艾滋病合并马尔尼菲青霉菌病33例临床研究
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周国强

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R512.91 R379.9

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A clinical study on 33 cases of Penicilliosis marneffei in patients with acquired immunodeficiency syndrome
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    摘要:

    目的了解某院艾滋病(AIDS)合并马尔尼菲青霉菌病(PSM)患者的流行病学特点、临床特征、处理及预后。方法对2008年1月—2011年8月该院艾滋病科AIDS合并PSM的住院患者病历资料进行回顾性研究。结果共收集33例AIDS合并PSM患者资料,其中54.55%的患者发病前一直居住于湖南,45.45%的患者来源于或曾经去过广东、广西、云南、福建省等传统马尔尼菲青霉菌(PM)疫区。该病最常见的临床症状、体征为以高热为主的发热(96.97%)、贫血(93.94%),其次为咳嗽(66.67%)、脾大(63.64%)、皮疹(57.58%),亦有淋巴结大(39.39%)和腹泻(33.33%)等症状。所有患者CD4+T淋巴细胞计数均<200/mm3,其中25例(75.76%)<50/mm3, 7例介于50~100/mm3, 1例>100/mm3。给予两性霉素B和伊曲康唑治疗,总治愈好转率为84.85%。结论对AIDS患者,根据其流行病学及临床特征和血培养PM阳性结果早期诊断PSM,积极治疗,能取得满意疗效。

    Abstract:

    ObjectiveTo evaluate the epidemiology, clinical features, treatment and prognosis of Penicilliosis marneffei (PSM) complicated in patients with acquired immunodeficiency syndrome (AIDS) in a hospital.MethodsClinical data of AIDS inpatients with PSM between January 2008 and August 2011 were studied retrospectively.ResultsClinical data of 33 patients were collected. Before the onset of disease, 54.55% of the patients had been living in Hunan, 45.45% came from or have ever been to Penicillium marneffei (PM) endemic areas of Guangdong, Guangxi, Yunnan, and Fujian. The major clinical manifestations were fever (96.97%), anaemia (93.94%), cough (66.67%), splenomegaly (63.64%), skin rash (57.58%), lymphadenectasis (39.39%) and diarrhea(33.33%). CD4+T lymphocyte count of all patients were <200/mm3, and the number of the patients with CD4+ count in 100-200/mm3,50-100/mm3 and <50/mm3 ranges were 1,7 and 25, respectively. After treated with amphotericin B and/or itraconazole,the total cure and improvement rate was 84.85%.ConclusionWith regard to PSM complicated in AIDS patients, early diagnosis and prompt treatment can achieve ideal therapeutic effet.

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周国强,肖钢,王敏.艾滋病合并马尔尼菲青霉菌病33例临床研究[J]. 中国感染控制杂志,2012,11(6):413-416.
ZHOU Guoqiang, XIAO Gang, WANG Min. A clinical study on 33 cases of Penicilliosis marneffei in patients with acquired immunodeficiency syndrome[J]. Chin J Infect Control, 2012,11(6):413-416.

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  • 收稿日期:2012-02-22
  • 最后修改日期:2012-04-10
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  • 在线发布日期: 2012-11-30
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