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目的探讨艾滋病相关淋巴瘤的临床特点与治疗措施。方法对10例HIV感染者合并淋巴瘤(均为男性,年龄25~66岁)术前和术后检测免疫功能,规范手术操作程序,精细操作减少手术损伤,对合并血友病患者术中持续输注Ⅷ因子,常规应用抗生素预防感染,及时处理并发症。给予高效价抗逆转录病毒治疗和CHOP方案全身化疗。结果患者手术前CD4 T淋巴细胞(173.2±108.8)cell/μl,手术后2周复查CD4 T淋巴细胞(169.3±111.6)cell/μl,差异无统计学意义(P>0.05)。手术均顺利,仅1例伤口感染,无严重手术并发症。3例在术后3~7个月死亡,另7例在治疗和随访中,已随访6~24个月。结论艾滋病相关淋巴瘤患者免疫功能明显低下,CD4 T淋巴细胞明显低于正常人群。但是早期手术切除病灶,合适的抗病毒治疗加全身化疗可能取得较好的疗效。
Objective To investigate the clinical features and treatment of AIDS-related lymphoma. Methods Ten cases of HIV-infected patients with lymphoma (both men, aged 25 to 66 years) were immunized before and after surgery to regulate the operation procedures, fine operation to reduce the surgical injury, surgery in patients with hemophilia continued Infusion Ⅷ factor, routine use of antibiotics to prevent infection, timely treatment of complications. Give high titer antiretroviral therapy and CHOP regimen systemic chemotherapy. Results The number of CD4 T lymphocytes (173.2 ± 108.8) cells / μl before operation and the number of CD4 T lymphocytes (169.3 ± 111.6) cells / μl 2 weeks after operation were not significantly different (P> 0.05). Surgery were smooth, only 1 case of wound infection, no serious surgical complications. Three patients died 3 to 7 months after surgery. The other 7 patients were followed up for 6 to 24 months during treatment and follow-up. Conclusion The immune function of patients with AIDS-related lymphoma is significantly lower, CD4 T lymphocytes was significantly lower than the normal population. However, early surgical resection of lesions, appropriate antiviral therapy plus systemic chemotherapy may achieve better results.