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目的:调查已接受高效抗逆转录病毒治疗(HAART)的艾滋病(AIDS)患儿口腔健康状况和免疫功能,探讨其相关关系及与HAART治疗的时相关系。方法:纳入2010年2～8月期间由广西壮族自治区疾病预防控制中心确诊的AIDS患儿49例,通过病史采集,口腔专科检查收集临床资料,并结合辅助检测获得患儿唾液念珠菌负荷,治疗基线及治疗后外周血CD4+T淋巴细胞绝对数及百分比等数据,进行相关分析。结果:49例AIDS患儿均接受HAART,其中男25例,女24例,年龄3～11岁,平均6.18±2.05岁,共14例(28.6%)存在口腔黏膜病损,依次为口腔念珠菌病8例,口腔溃疡5例,带状疱疹1例。全部患儿中,有31例检出口腔念珠菌(63.3%)。患儿治疗基线及治疗后CD4+T淋巴细胞百分比均数分别为0.162±0.110和0.309±0.063(P<0.01),治疗后的CD4+T淋巴细胞百分比明显高于治疗基线水平。免疫抑制程度与HAART时限之间呈负相关关系(r=-0.418,P=0.003),而与口腔病损之间呈正相关关系(r=0.322,P=0.024)。结论:HAART能明显提高艾滋病儿童的免疫功能,但在HAART治疗期间,口腔病损的存在提示艾滋病患儿处于免疫抑制状态。
Objective: To investigate the oral health status and immune function of children with AIDS who have received HAART, and to explore their relationship and the relationship with HAART treatment. Methods: Forty-nine AIDS patients diagnosed by CDC of Guangxi Zhuang Autonomous Region from January to August in 2010 were enrolled in this study. Their clinical data were collected through medical records and oral examinations. Candida salivarius load was obtained in combination with ancillary tests. Baseline and after treatment of peripheral blood CD4 + T lymphocytes and the absolute percentage and other data were analyzed. Results: 49 cases of AIDS patients received HAART, including 25 males and 24 females, aged 3 to 11 years, mean 6.18 ± 2.05 years old, a total of 14 cases (28.6%) of oral mucosal lesions, followed by oral Candida 8 cases of disease, oral ulcer in 5 cases, 1 case of shingles. Of the total children, 31 had oral candidiasis (63.3%). The mean percentage of CD4 + T lymphocytes in children with treatment baseline and after treatment was 0.162 ± 0.110 and 0.309 ± 0.063, respectively (P <0.01). The percentage of CD4 + T lymphocytes after treatment was significantly higher than the baseline level. There was a negative correlation between the degree of immunosuppression and the HAART duration (r = -0.418, P = 0.003), but negative correlation with oral lesions (r = 0.322, P = 0.024). Conclusion: HAART can obviously improve the immune function of children with AIDS, but the presence of oral lesions suggests that AIDS patients are immunosuppressed during HAART.