综合性医院内获得性免疫缺陷综合征肺部病变临床分析

【】　目的　探讨综合性医院内获得性免疫缺陷综合征（acquiredimmunedeficiencysyndrome，AIDS）患者的肺部表现及其特征。　方法　回顾性分析2006年2月－2009年12月收治的58例AIDS患者肺部病变的临床资料。　结果　58例患者中男47例，女11例，男女比例为4.27∶1；年龄6~78岁，平均43岁，其中50岁22例，占37.9%。肺部表现是AIDS患者入住综合性医院的常见临床表现，居各种临床表现的首位（占55.2%）。主要有弥漫性肺部疾病和肺结核，分别是21例（36.2%）和23例（39.7%），收治的主要科室是呼吸内科38例（65.5%）和传染科12例（20.7%）；常见的临床症状有发热、咳嗽、活动后气促或呼吸困难；其肺部影像学表现多样，有毛玻璃样变、弥漫性结节影、斑片影、肺内块影或肺内空洞、纤维条索影或伴胸水；其常见伴随症状有口腔溃疡真菌、腹泻或其他消化道症状，及其皮疹、贫血、神经系统症状等；同时也有部分患者合并乙型肝炎病毒/丙型肝炎病毒/梅毒等混合感染。　结论　AIDS的肺部病变是综合性医院住院AIDS患者的主要表现，提高呼吸科医师对AIDS患者肺部表现的认识将有利于AIDS的临床防治。【Abstract】　Objective　Toinvestigatetheclinicalcharacteristicsofacquiredimmunedeficiencysyndrome(AIDS)withpulmonarydiseasesincomprehensivehospitals.　Methods　Theclinicaldataof58casesofAIDSwithpulmonarydiseasesadmittedinourhospitalfrom2006to2009wereanalysedretrospectively.　Results　Amongthepatients,therewere47malesand11females,andtheproportionofthenumberofmalestofemaleswas4.27∶1.Theiragerangedfrom6to78yearsold,averagingat43.Thirty-sixpatients(62.07%)wereunder50yearsold;andtherewere22patients(37.93%)aged50orabove.ThepulmonaryexpressionwascommoninAIDSpatientsadmittedintocomprehensivehospitals,occupyingthefirstplaceinvariousclinicalmanifestatiosn(55.24%).PulmonaryexpressionsofAIDSweremainlydiffusepulmonarydiseasesandpulmonarytuberculosis,whichhad21(36.21%)and23(39.66%)casesrespectively.ChieftreatingdepartmentswereDepartmentofRespiratoryMedicine(65.52%)andDepartmentofInfectiveDiseases(20.69%).Itscommonsymptomsincludedfever,cough,shortnessofbreathafteractivitiesordyspnea;Itspulmonaryimagehadvariousmanifestationsincludingground-glassopacity(GGO),diffusenodalshadow,spotandthinpieceshadow,pulmonarychunkshadoworcavity,fibretwigsshadowor/andhydrothorax;Itscommoncombinedsymptomsincludedoralcavityulcerfungusinfection,diarrhoeaorotherdigestivetractsymptoms,anderythra,anemia,andnervussystemsymptoms,etc.TherewerestillsomeothercasesofcombinedviralhepatitistypeB,typeC,orsyphilis.　Conclusion　PulmonarydiseasesofAIDSarethemainexpressionsofpatientswithAIDSincomprehensivehospitals.ItwillbebeneficialtoclinicalprophylaxisandtreatmentofAIDStoheightentheknowledgeofrespiratoryphysiciansonpulmonaryexpressionsofpatientswithAIDS.