综合性医院165例艾滋病住院患者流行病学与临床特征分析

Analysis of epidemiological and clinical characteristics of 165 AIDS inpatients in the general hospital

目的了解艾滋病住院患者临床特征与治疗方案,以提高艾滋病科学防治水平。方法回顾分析2017年1月1日—2021年12月31日安徽医科大学第一附属医院感染病科住院治疗的165例艾滋病患者的病历资料,包括性别、年龄、感染途径等流行病学数据及起病症状、首诊科室、血红蛋白、CD4^(+)T淋巴细胞计数、HIV-RNA等临床数据。结果共纳入165例患者中男性占89.70%,平均年龄(42.57±13.62)岁;农民、无业与待业人员及公司职员为主要感染人群,感染途径以性接触为主;起病症状多样,71.52%患者于感染科首次就诊,发热为首发症状;52.12%患者出现贫血,84.80%患者CD4^(+)T淋巴细胞计数<200个/微升;HIV-RNA平均载量为[1.52×10^(5)(1.95×10^(5))]拷贝/毫升,肺孢子菌肺炎是发生率最高的机会性感染,其次为口腔念珠菌感染;117例接受拉米夫定+替诺福韦+依非韦伦方案进行抗病毒治疗。结论加强对高危人群宣传教育,降低感染率;艾滋病患者常因其他疾病就诊于综合性医院不同科室,相关医护人员应提高警惕,减少漏诊误诊;及时有效地控制机会性感染与肿瘤,适时启动高效抗逆转录病毒治疗,有利于提高患者生存率与生活质量。

Objective To understand the clinical characteristics and treatment of AIDS inpatients so as to improve the level of scientific prevention and treatment of AIDS.Methods This study retrospectively analyzed the medical records of 165 AIDS patients who were hospitalized in the Department of Infectious Diseases,The First Affiliated Hospital of Anhui Medical University from January 1,2017 to December 31,2021.The records included epidemiological data such as gender,age,route of infection,and clinical data such as onset symptoms,first diagnosis department,hemoglobin,CD4^(+)T lymphocyte count and HIV-RNA.Results 89.70%of all 165 patients included were male,with an average age of(42.57±13.62)years old.Farmers,the unemployed and company employees were the main infection groups,and the main route of infection was sexual contact.The onset symptoms were varied.71.52%of the patients visited the Department of Infectious Diseases for their first diagnosis,and fever was the first symptom.Anemia occurred in 52.12%of the patients,and CD4^(+)T lymphocyte count was less than 200/μL in 84.80%of the patients.The average HIV-RNA load was[1.52×10^(5)(1.95×10^(5))]copies/mL.Pneumocystis pneumonia was the opportunistic infection with highest incidence,followed by oral candidiasis.117 patients received the antiviral therapy with lamivudine+tenofovir+efavirenz regimen.Conclusion It is necessary to strengthen the publicity and education about AIDS for high-risk groups to reduce the infection rate.AIDS patients often go to different departments of general hospitals for other diseases.Relevant medical staff should be vigilant to reduce the cases of missed diagnosis and misdiagnosis.Timely and effective control of opportunistic infections and tumors,and timely initiation of highly effective antiretroviral therapy are beneficial to improve the survival rate and life quality of patients.