以中枢神经系统症状为首发HIV患者的临床特点

Clinical analysis of HIV-Starting with central nervous system lesions in patients

目的 回顾性分析以中枢神经系统症状为首发表现HIV患者的临床特点。方法 对2008年1月1日-2015年12月31日在南京脑科医院住院诊断HIV,具有以中枢神经系统症状为首发表现的39例患者的临床资料,进行回顾性分析研究。结果 研究人群的平均年龄为40.9±9.4岁,平均CD4细胞计数为55cells/mm3（QR：25-105）。最常见的临床表现为头痛（87.2%）,体重下降（71.8%）,发热（66.7%）。弓形虫脑炎（28.2%）、艾滋病痴呆综合征（17.9%）、原发性中枢神经系统淋巴瘤（PCNSL）（15.4%）、不明原因的CNS感染（15.4%）和隐球菌脑膜炎（12.8%）、结核性脑膜炎（12.8%）、不明原因的颅内占位性病变（12.8%）是艾滋病毒相关的中枢神经系统疾病表现的主要病因。结论 HIV-相关的中枢神经系统疾病越来越常见,临床表现复杂多样,易误诊,应提高警惕,留意抗HIV抗体的筛查。

Objective The present study aimed to determine clinical presentation of HIV-associated central nervous system lesions in patients as the first presentation.Methods A retrospective study of 39 patients with HIV-associated cen-tral nervous system lesions who were hospitalized at Nanjing Brain Hospital from January 1st 2008 to December 31st 2015 was carried out.Results The mean age of the study population was 40.9 ±9.4 years,and median CD4 count was 55 cells/mm（3） （interquartile range （QR：25 -105）.The most common clinical presentations were headache （87.2%）, Weight loss （71.8%）, and fever （66.7%）.Toxoplasma encephalitis （28.2%）, AIDS dementia complex （ ADC） （17.9%）,primary central nervous system lymphoma（PCNSL）（15.4%）,unexplained encephalitis（15.4%）and Strepto-coccus meningitis （12.8%）、 Tuberculous meningitis （12.8%）、 intracranial space occupying lesion of unknown origin （12.8%）were the leading aetiologies of HIV-associated CNS disease of patients.Conclusion HIV-associated CNS dis-ease is common among HIV patients.CNS symptoms of these diseases are complex and sometimes easy to be misdiagnosed. We should pay attention to screening of anti-HIV antibody.