以消化系统疾病首诊的HIV/AIDS患者的临床特点分析

阴绯; 周卫红

doi:10.3969/j.issn.1001-5256.2016.07.037

以消化系统疾病首诊的HIV/AIDS患者的临床特点分析

DOI: 10.3969/j.issn.1001-5256.2016.07.037

阴绯,
周卫红

1. 四川省凉山彝族自治州第二人民医院消化科
2. 四川省凉山彝族自治州中西医结合医院

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中图分类号: R512.91
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出版历程
- 出版日期: 2016-07-20

Clinical features of HIV/AIDS patients with digestive diseases

摘要

摘要:
目的通过对以消化系统疾病为首诊入院且合并人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）患者的临床资料进行分析,以期指导临床诊断。方法收集四川省凉山彝族自治州第二人民医院2013年1月-2014年12月所有因消化系统症状入院的HIV/AIDS患者的流行病学资料及临床症状体征、辅助检查及并发症等情况,分析各观察指标的特征。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果共纳入消化系统疾病合并HIV/AIDS患者95例,其中男∶女=1.4∶1,3050岁患者57例（60%）,彝族85例（89.47%）,农民86例（90.53%）。通过性传播46例（48.42%）,静脉吸毒传播44例（46.32%）。纳入患者中常见的临床症状依次为腹痛（71.58%）、发热（43.16%）、腹泻（17.89%）;常见的体征为腹水（28.42%）、浅表淋巴结肿大（21.05%）、肝脾肿大（16.84%）;辅助检查肝功能指标中球蛋白明显升高;机会性感染达83.16%,以肺部和消化道感染为主,霉菌性食管炎占胃镜检查者的31.58%;非感染性并发症...
- 消化系统疾病 /
- HIV /
- 获得性免疫缺陷综合征 /
- 重叠感染
Abstract:
Objective To analyze the clinical data of patients admitted with an initial diagnosis of digestive diseases who have human immunodeficiency virus( HIV) / acquired immune deficiency syndrome( AIDS),and to guide clinical diagnosis. Methods The clinical data of HIV / AIDS patients who were hospitalized due to digestive system symptoms from January 1,2013 to December 31,2014 were collected,including epidemiological data,clinical symptoms and signs,auxiliary examinations,and complications. The features of each parameter were observed. The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups. Results A total of 95 HIV / AIDS patients with digestive diseases were enrolled,and the male / female ratio was1. 4∶ 1. Among these patients,57( 60%) were aged 30- 50 years,85( 89. 47%) were Yi people,and 86( 90. 53%) were farmers. Of all patients,46( 48. 42%) were infected via sexual transmission and 44( 46. 32%) were infected via intravenous drug use. In these patients,common clinical symptoms included abdominal pain( 71. 58%),pyrexia( 43. 16%),and diarrhea( 17. 89%),and common signs included ascites( 28. 42%),superficial lymphadenectasis( 21. 05%),and hepatosplenomegaly( 16. 84%). The auxiliary examination showed a significant increase in globulin. The proportion of patients with opportunistic infection reached 83. 16%,mainly lung and digestive tract infections. Among the patients who underwent gastroscopy,31. 58% had mycotic esophagitis. Chronic non- atrophic gastritis,electrolyte disturbance,and intestinal obstruction were commonly seen in patients with noninfectious complications. Of all HIV / AIDS patients,54. 74%( 52 /95) were complicated by HBV and / or HCV infection,and the liver function parameters globulin,total bilirubin,aspartate aminotransferase,alanine aminotransferase,and A / G showed significant differences between these patients and the patients with HIV infection alone( all P < 0. 01). Conclusion HIV infection should be highly suspected in patients who visit the department of gastroenterology due to abdominal pain and diarrhea,have clinical manifestations of ascites,superficial lymphadenectasis,and hepatosplenomegaly,and are complicated by opportunistic infection in the lungs and digestive tract,especially those with histories of drug use and unprotected sex. Meanwhile,HBV and / or HCV infection may aggravate patients' condition and should be taken seriously.
- digestive system diseases /
- HIV /
- acquired immunodeficiency syndrome /
- superinfection

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