人类免疫缺陷病毒感染者胃镜特点分析

发布时间：2018-01-16 19:25

本文关键词：人类免疫缺陷病毒感染者胃镜特点分析　出处：《中国现代医学杂志》2016年19期 　论文类型：期刊论文

【摘要】：目的了解人类免疫缺陷病毒(HIV)感染者胃镜特点。方法选取2010年12月-2015年11月于北京佑安医院确诊HIV感染者胃镜结果及临床、病理资料,进行统计分析。结果 5年共行HIV感染者胃镜检查283例次,门诊124例(43.8%),住院159例(56.2%);男∶女约为7∶1;年龄(39.3±12.4)岁。CD4+T淋巴细胞计数(229.0±21.4)个/μl,200个/μl有73例,接受高效抗反转录病毒治疗(HAART)221例(92.5%),幽门螺旋杆菌阳性率为26.8%。主诉症状中腹胀和上腹痛最常见,分别为32.2%(79/245)和22.9%(56/245),其次为胸痛、消化道出血、反酸或烧心、恶心或呕吐、吞咽困难等。胃镜主要表现为慢性非萎缩性胃炎30.2%(74/245)、反流性食管炎16.7%(41/245),其次为胆汁反流性胃炎、慢性萎缩性胃炎、胃溃疡、食管溃疡等。结合临床与病理明确诊断恶性肿瘤16例(6.5%),其中胃癌7例,卡波西肉瘤5例,非霍奇金淋巴瘤4例。机会性感染均发生在食管,真菌感染6例(2.4%),结核感染12例(4.9%),巨细胞病毒感染4例(1.6%)。结论 HIV感染者消化道症状并无特异性,但胃镜下异常病变(包括各种机会感染、恶性肿瘤等)检出率高,且症状与疾病严重程度并不一致,故对有症状者仍应尽可能行胃镜检查。
[Abstract]:Objective to investigate the gastroscopy characteristics of HIV infected patients with HIV. Methods from December 2010 to November 2015, the gastroscopy results and clinical features of HIV infected patients were selected. Results in 5 years, 283 cases of HIV infected patients were examined by gastroscopy, 124 cases were diagnosed 43.8% and 159 cases were hospitalized. Male: female is about 7: 1; Age was 39.3 卤12.4 years old. CD4 T lymphocyte count was 229.0 卤21.4 / 渭 l, and 73 cases were 200 / 渭 l. 221 cases of HAART were treated with highly effective antiretrovirals. The positive rate of Helicobacter pylori was 26.8.The abdominal distention and epigastric pain were the most common symptoms. It was 32.2and 22.9m 56 / 245g respectively, followed by chest pain, gastrointestinal bleeding, acid regurgitation or heartburn, nausea or vomiting. The main manifestations of gastroscopy were chronic non-atrophic gastritis (30. 2%), reflux esophagitis (16. 7%) and bile reflux gastritis (45%), followed by bile reflux gastritis. Chronic atrophic gastritis, gastric ulcer, esophageal ulcer, etc. Combined with clinical and pathological diagnosis, 16 cases of malignant tumor were confirmed, including 7 cases of gastric cancer, 5 cases of Kaposi's sarcoma. There were 4 cases of non-Hodgkin 's lymphoma. Opportunistic infection occurred in esophagus, fungal infection occurred in 6 cases (2.4%), tuberculosis in 12 cases (4.9%). Conclusion there is no specificity in gastrointestinal symptoms in patients with HIV infection, but the detection rate of abnormal lesions under gastroscopy (including opportunistic infections, malignant tumors, etc.) is high. The severity of the disease is not consistent with the symptoms, so gastroscopy should be performed as far as possible for those with symptoms.
【作者单位】：首都医科大学附属北京佑安医院肝病消化中心;首都医科大学附属北京佑安医院病理中心;
【分类号】：R512.91;R573
【正文快照】： 1:2010年12月-2011年11月;2:2011年12月-2012年11月;3:2012年12月-2013年11月;4:2013年12月-2014年11月;5:2014年12月-2015年11月附图HIV感染者胃镜数量年变化趋势1 2 3 4 5120100806040200例数消化道症状是人类免疫缺陷病毒(human im-munodeficiency virus,HIV)感染者重要的

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