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目的探讨深圳市艾滋病患者的临床、流行病学及并发症,探索高效抗逆转录病毒治疗(HAART)的疗效及白介素-Ⅱ(IL-Ⅱ)免疫重建的效果。方法对77例住院病人的临床流行病学、并发症、抗病毒治疗和白介素-Ⅱ免疫重建进行回顾性分析。结果77例病人的平均发病年龄29.01岁;感染途径以性乱为主,单纯性乱占64.7%(包括男男同性性乱14%),性乱加吸毒占14.6%,其他有输血感染。并发症以呼吸系统为主,消化系统次之,血液及泌尿生殖系统排在其后。两个系统以上受累的占91%。病原以结核杆菌最多,占37.7%;肺孢子虫肺炎次之,占29.8%;再者为细菌性肺炎,占28.6%。共住院100人次,人均住院1.3次,每次住院22.08天,中位数19.14天。人均费用810.8元/天,中位数614.3元/天。44例HAART治疗后CD3+、CD4+细胞明显上升(P<0.001),CD4+/CD8+比例增高,CD8+下降(P<0.01)。对6例经HAART治疗后仍出现机会性感染的病例,给予白介素-Ⅱ治疗后CD3+、CD4+明显上升(P<0.001),CD4+/CD8+比例上升,CD8+下降(P<0.01)。结论深圳市HIV感染已由高危人群向普通人群扩散,临床应注意误诊漏诊。HAART是提高存活率的关键,对部分经HAART治疗后仍出现机会性感染的患者,给予白介素-Ⅱ可提高CD3+、CD4+T淋巴细胞,降低CD8+T淋巴细胞,达到免疫重建的目的。
Objective To investigate the clinical, epidemiological and complications of AIDS patients in Shenzhen and to explore the efficacy of high effective antiretroviral therapy (HAART) and immune reconstitution of interleukin-Ⅱ (IL-Ⅱ). Methods The clinical epidemiology, complications, anti-virus therapy and interleukin-Ⅱ immune reconstitution in 77 inpatients were analyzed retrospectively. Results The average age of onset of the 77 patients was 29.01 years old. The main route of infection was sexual disorder, which accounted for 64.7% (including 14% for MSM), 14.6% for sexual abuse and other drugs, and other transfusion infections. Complications to the respiratory system, followed by the digestive system, followed by the blood and genitourinary system. Two systems accounted for more than 91%. Pathogen to Mycobacterium tuberculosis, accounting for 37.7%; pneumocystis pneumonia followed, accounting for 29.8%; again for bacterial pneumonia, accounting for 28.6%. A total of 100 people were hospitalized, per capita hospital 1.3 times, each hospital 22.08 days, the median 19.14 days. Per capita cost 810.8 yuan / day, the median 614.3 yuan / day. After 44 cases of HAART treatment, CD3 + and CD4 + cells increased significantly (P <0.001), the proportion of CD4 + / CD8 + increased and CD8 + decreased (P <0.01). In 6 cases of opportunistic infections after HAART, the levels of CD3 + and CD4 + were significantly increased (P <0.001), the proportion of CD4 + / CD8 + was increased and CD8 + was decreased (P <0.01). Conclusion HIV infection in Shenzhen has spread from the high-risk population to the general population, so it is necessary to pay attention to misdiagnosis and missed diagnosis in clinical practice. HAART is the key to improve the survival rate. Some patients who still have opportunistic infection after HAART treatment may be given interleukin-II to raise CD3 +, CD4 + T lymphocytes and CD8 + T lymphocytes to achieve immune reconstitution.