AIDS合并肺部感染90例分析

Clinical Analysis of 90 AIDS Patients with Pulmonary Infections

目的 提高对艾滋病 (AIDS)合并肺部感染的认识。方法 对 1995～ 2 0 0 1年在佑安医院就诊的 90例AIDS合并肺部感染的患者进行分析。结果 ( 1)结核病 (TB) 3 8例 ( 4 2 2 % ) ,卡氏肺孢子虫肺炎 (PCP) 3 5例( 3 8 9% ) ,肺隐球菌病 2例 ( 2 2 % ) ,军团菌肺炎 2例 ( 2 2 % ) ,非何杰金氏淋巴瘤 1例 ( 1 1% ) ,其它不明原因肺部感染 12例 ( 13 3 % )。 ( 2 ) 90例肺部感染的患者中 ,CD+ 42～ 3 4 0 /μl ,平均CD+ 412 5± 86/μl,CD+ 4/CD+ 80 .0 1～ 0 .51。其中CD+ 4>2 0 0 /μl 7例 ( 7 8% ) ,CD+ 410 0～ 2 0 0 /μl 19例 ( 2 1 1% ) ,CD+ 4<10 0 /μl 64例 ( 71.1% )。结论 中国成人AIDS合并肺部感染以TB和PCP为主。AIDS患者在CD+ 4<2 0 0 /μl时容易并发肺部感染 ,其中以CD+ 4<10 0 /μl时较为常见 ;CD+ 4越低 。

objective To increase the awareness of pulmonary infections in patient s with AIDS. Method Ninety cases of AIDS with pulmonary infection from 1995-2001 were analyzed. Results (1) Of the 90 cases, tuberculosis was present in 38 case s(42.2%), pneumocystis carnii pneumonia(PCP) in 35 (38.9%), pulmonary cryptococu s in 2 (2.2%), Legionaire's pneumonia in 2 (2.2%), non-Hodgkin's lymphoma in 1 ( 1.1%), and other undiagnosed pneumonias in 12 (13.3%). (2)CD + 4count: CD + 4cell r anged from 2 to 340/μl, mean CD + 4count 125+86/μl, and the ratio of CD + 4/CD + 8ranged between 0.01 and 0.51. CD + 4 was greater than 200/μl in 7(7.8%) cases, bet ween 100 and 200 /μl in 19(21.1%), and less than 100/μl in 64(71.1%). Conclusion Tuberculosis and PCP are the predominant types of opportunistic infections in AIDS patients with pulmonary infection. Pulmonary infection primarily occurred in patients with a CD + 4 count less than 200/μl, particularly patients with a CD + 4 coun t less than 1 00ul. Lower CD + 4 counts were correlated with more serious pulmonary infect ion.