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目的了解痒疹(PPE)在艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)中的发生情况、临床和组织病理特点,以及患者的免疫功能。方法收集乌干达金贾医院皮肤科及艾滋病科2年多HIV/AIDS病人的PPE临床资料,部分进行CD4~+T淋巴细胞(简称CD4细胞)检查及皮损组织病理检查。结果 1 429例HIV/AIDS病人中,患PPE 305例(21.3%)。男∶女为1∶1.48;年龄19~60岁,中位年龄35岁[四分位数间距(IRQ)28~40岁]。PPE在未接受抗反转录病毒治疗(ART)的HIV/AIDS病人中的患病率为33.3%(279/837),在行ART病人中的患病率为4.4%(26/592)。279例未接受ART病人的中位病程6个月(IRQ 2-12个月)。PPE表现为瘙痒剧烈的丘疹、结节性痒疹,全身对称发生;42例(13.8%)PPE为HIV感染的首发表现;31例PPE主要病理改变为真皮血管周围有显著的单核细胞及嗜酸性粒细胞致密浸润;217例PPE患者的CD4细胞计数为4~770个/mm~3,中位CD4细胞计数为41个/mm~3(IQR:21~143个/mm~3),84.2%的病例的CD4细胞计数<200个/mm~3。结论 PPE在HIV/AIDS病人中发病率高,ART能改善PPE并降低患病率。PPE的主要病理改变为真皮血管周围显著的单核细胞及嗜酸性粒细胞浸润。
Objective To understand the occurrence, clinical and histopathological features of prurigo (PPE) in HIV / AIDS patients (HIV / AIDS patients) and the immune function of patients. Methods The PPE clinical data of patients with dermatology and AIDS in the Department of Dermatology and AIDS of Uganda Hospital for more than two years were collected. The CD4 ~ + T lymphocytes (CD4 cells for short) and histopathological examination of the lesions were collected. Results Among the 1 429 HIV / AIDS patients, 305 patients (21.3%) had PPE. Male: Female: 1: 1.48; aged 19 to 60 years with a median age of 35 years [interquartile range (IRQ) 28-40 years]. The prevalence of PPE in HIV / AIDS patients who did not receive antiretroviral therapy (ART) was 33.3% (279/837) and in ART patients 4.4% (26/592). The median course of 279 ART patients who did not receive ART was 6 months (IRQ 2-12 months). 42 cases (13.8%) PPE were the first manifestation of HIV infection; 31 cases of PPE main pathological changes were dermal perivascular significant monocytes and eosinophils The number of CD4 cells in 217 patients with PPE was 4 ~ 770 cells / mm ~ 3, the median CD4 cell count was 41 cells / mm ~ 3 (IQR: 21 ~ 143 cells / mm ~ 3), 84.2% Of CD4 cell counts <200 cases / mm ~ 3. Conclusions PPE has a high incidence in HIV / AIDS patients and ART can improve PPE and reduce the prevalence. The main pathological changes of PPE were significant mononuclear cells and eosinophil infiltration around dermal vessels.