艾滋病肺部合并症六例分析

陆慰萱　李龙芸　盛瑞媛 中华结核和呼吸感染 1999年第8期第22卷 论著

　　【摘要】　目的　提高对艾滋病肺合并症的认识。方法　对1992年3月～1997年8月间诊断的6例艾滋病患者进行分析。结果　并发卡氏肺囊虫性肺炎（PCP）5例（其中1例为艾滋病首发表现），其临床表现为发热（5/5），呼吸困难（4/5）和低氧血症（5/5），平均动脉血氧分压为58 mm Hg(1 mm Hg=0.133 kPa )，胸部X片显示，两肺弥漫间质或肺泡性浸润。另有支气管真菌感染、肺结核和淋巴结结核各1例（痰抗酸杆菌阳性、结核菌素试验阴性）。结论　艾滋病容易发生各种肺合并症，尤以PCP多见。对既往身体健康的青壮年，如突然发生肺炎和呼吸衰竭应警惕PCP发生。 对特定情况下发生的肺机会性感染应警惕艾滋病，并及时检查血抗人类免疫缺陷病毒(HIV)抗体。

　　Study of 6 cases of AIDS with Pulmonary complication

　　LU Weixuan, LI Longyun, SHENG Ruiyuan.

　　Department of Respiratory Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730

　　【Abstract】　Objective　To improve and to increase the awareness of pulmonary complications of AIDS. Methods　Six cases of confirmed AIDS from may 1992 to August 1997 were analyzed. Results　Of the six cases, there were five complicated with pneumocysitis carinii pneumonia (PCP) (in which one had PCP as the first occurred manifestation)。The clinical presentations of PCP were fever(5/5), dyspnea on exertion or at rest(4/5), and hypoxemi with mean PaO2 of 58.1 mm Hg. Chest X-ray showed bilateral diffuse interstitial or alveolar infiltrates. Pulmonary tuberculosis, tuberculous lymphadenities (fast-acid staining positive but PPD negative ) and bronchial fungal infection were found in three cases. Conclusions　AIDS patients are at high risk of suffering from pulmonary complications, of which PCP is more common. If young pateints who were healthy in the past suddenly suffered from pneumonia and respiratory failure , PCP should be considered. When opportunistic pulmonary infections are diagnosed under special circumstances, one should be alert to the possibility of AIDS. In these cases serum HIV antibodies should be checked immediately.

　　【Key words】　Acquired immunodeficiency syndrome　　Lung　　Opportunistic infections

　　艾滋病又称获得性免疫缺陷综合征（AIDS)，在全世界范围内广泛流行，已成为举世瞩目的重大公共卫生和社会问题。当前艾滋病在我国也呈加速流行趋势，形势严峻。据1998年6月底报告,已有10 67

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