25例艾滋病合并卡波西肉瘤患者临床特征分析

Clinical feature analysis of 25 AIDS patients with Kaposi’s sarcoma

目的对艾滋病合并卡波西肉瘤患者的临床特征、治疗及预后情况等进行探讨。方法收集2012年7月—2020年9月广州医科大学附属市八医院首次诊治的25例艾滋病合并卡波西肉瘤患者的临床资料,对临床特征、不同化疗方案患者的生存及不良反应进行回顾性分析。结果25例艾滋病合并卡波西肉瘤患者中,15例>35岁,16例CD4+T淋巴细胞计数<200 cells/ml,14例HIV RNA<100000 IU/ml,5例患者在确诊前已开始抗反转录病毒治疗。与单药组相比,异环磷酰胺+脂质体阿霉素组在化疗4程后较快获得完全缓解(P<0.05),但化疗结束后总生存率之间差异无统计学意义(P>0.05),化疗不良反应稍大。结论艾滋病合并卡波西肉瘤好发于免疫力较差的中青年男性,合并机会性感染可能性大,尽量选择整合酶抑制剂抗反转录病毒治疗,异环磷酰胺+脂质体阿霉素组较单药组可能更早获得完全缓解,但骨髓抑制及脱发不良反应稍高,临床上可根据患者一般情况、疾病进展快慢及要求选择治疗方案。

Objective To investigate the clinical feature,therapy and prognosis in AIDS patients with Kaposi’s sarcoma.Methods Clinical data of 25 AIDS patients with Kaposi’s sarcoma who were first admitted to Guangzhou Eighth People’s Hospital,Guangzhou Medical University from July 2012 to September 2020 were collected,and their clinical feature,survival and adverse reactions of patients with different chemotherapy regimens were retrospectively analyzed.Results Among 25 AIDS patients with Kaposi’s sarcoma,15 cases aged>35 years,16 cases had CD4+T lymphocyte count of<200 cells/ml and 14 cases had HIV RNA of<100000 IU/ml.Five patients have undergone antiretroviral therapy prior to the diagnosis.Compared with mono-therapy groups,the ifosfamide+liposomal doxorubicin group achieved complete remission quickly after 4 cycles(P<0.05),but there was no significant difference in overall survival after the chemotherapy was completed(P>0.05)and exhibited slightly greater adverse reactions to chemotherapy.Conclusions AIDS patients with Kaposi’s sarcoma usually occurs in middle-aged and young men with poor immunity,and has a higher incidence of opportunistic infections.Integrase inhibitor antiretroviral therapy is preferred.Ifosfamide+liposomal doxorubicin may obtain complete remission earlier than the mono-therapy,but the incidence of adverse reactions(bone marrow suppression and alopecia)is higher.Therefore,treatment regimen can be selected according to the general condition,the speed of disease progression and the requirements of patients.