综合医院住院患者合并AIDS/HIV感染85例临床特征分析

Clinical characteristics of 85 hospitalized patients complicated with AIDS/HIV infection in a general hospital

目的探讨综合医院住院患者合并AIDS/HIV感染的临床特征。方法回顾性总结2008-2017年本院各科住院患者中合并AIDS/HIV感染患者一般资料、临床表现、实验室检查等,分析其特点。结果共发现合并AIDS/HIV感染患者85例,男78例,女7例,平均年龄41.26±14.00岁;分布于全院17个科室。其中皮肤科21例(24.70%);内科包括急诊内科、中医科在内总计50例,以呼吸内科最多19例(22.35%);外科14例。伴有发热44例(51.76%),体质量下降27例(31.76%)。化验检查血白细胞总数下降17例,淋巴细胞百分比下降28例(32.94%),淋巴细胞计数下降32例(37.65%),血红蛋白下降21例,血小板减少11例;有41例患者(48.24%)伴有高密度脂蛋白下降。胸部CT间质性改变、炎症7例,弥漫性磨玻璃样改变10例,感染1例,占位性病变1例,结核1例。内科患者尤其呼吸内科部分患者病情危重,临床表现及化验检查有一定特征;皮肤科及外科多数患者临床表现缺乏明显特征性。结论 AIDS/HIV感染患者生存期间可就诊于综合医院各科室,并可能因临床表现的隐蔽性及临床医师的认识不足而以普通患者收入;除呼吸内科、皮肤科等重点科室应提高防范意识外,各科室医护人员均需提高警惕,避免漏诊误诊及延误治疗,降低医护人员职业暴露风险。

OBJECTIVE To explore the clinical characteristics of hospitalized patients with AIDS/HIV infection in a general hospital.METHODS The baseline clinical data,clinical manifestations and laboratory examination of the patients with AIDS/HIV infection who were hospitalized from 2008 to 2017 were retrospectively analyzed,and the clinical characteristics were observed.RESULTS Totally 85 patients were complicated with AIDS/HIV infection,including 78 males and 7 females,the average age was（41.26±14.00）years old.All of the patients distributed in17 departments of the hospital,21（24.70%）of whom distributed in the department of dermatology;totally 50 patients distributed in the internal medicine departments,including the emergency department and traditional Chinese medicine（TCM）department,19（22.35%）of whom distributed in the department of respiratory medicine;totally 14 patients distributed in the surgery departments.Totally 44（51.76%）patients were complicated with fever,27（31.76%）had the decline of body weight.The results of laboratory examinations showed that 17 patients had the decline of total white blood cell（WBC）counts,28（32.94%）had the decline of percentage of lymphocytes,21 patients had the decline of hemoglobin level,and 11 patients had the reduction of platelet level.It was worth mentioning that there were 41（48.24%）cases of decreased high-density lipoprotein（HDL）.There were 7 cases of chest CT interstitial changes and inflammation,10 cases of diffuse ground-glass changes,1 case of infection,1 case of space-occupying lesions and 1 case of tuberculosis.The patients in the internal medicine department,especially in the respiratory medicine department,showed certain characteristics in clinical manifestations and laboratory examinations;most of the patients in the dermatology department and surgery departments did not show significant characteristics in the clinical manifestations.CONCLUSION The patients with AIDS/HIV infection can be treated in the departments of the general hospital during the survival period and possibly be enrolled as common patients due to the hidden clinical manifestations and insufficient cognition of doctors.It is necessary for the key departments such as the respiratory medicine department and dermatology department to attach great importance,the health care workers of all the departments should raise their vigilance so as to avoid the missed diagnosis and delayed treatment and reduce the risk of occupational exposure.