获得性免疫缺陷综合征的消化系统临床表现和肠镜特点分析（附109例报告）

Colonoscopic characteristics and clinical manifestation of digestive system of patients with acquired immunodeficiency syndrome (109 cases)

摘要:

目的 总结合并消化系统病变的获得性免疫缺陷综合征（AIDS）患者的主要临床表现和肠镜特点，以提高对合并消化系统疾病的AIDS患者的认识。方法 收集和分析2013年1月－2019年10月柳州市人民医院109例行结肠镜检查的人类免疫缺陷病毒（HIV）确诊感染者和116例HIV阴性行肠镜检查患者的临床资料，将HIV感染者（试验组）和HIV阴性患者（对照组）的临床表现和肠镜特点进行比较。同时根据CD4⁺ T淋巴细胞计数将HIV感染者分为两组进行对照分析，其中A组CD4⁺细胞 > 200×10⁶/L（n = 34）、B组 < 200×10⁶/L（n = 75）。结果 试验组肠镜下结直肠溃疡检出率和总体病变检出率明显高于对照组，两组比较，差异有统计学意义（P < 0.05）；B组肠镜下肠黏膜充血、糜烂和总体病变检出率明显高于A组，两组比较，差异有统计学意义（P < 0.05）。结论 AIDS患者比普通患者更容易出现结直肠溃疡，随着CD4⁺细胞计数下降，肠道炎症病变发生率和肠道病变总体发生率升高。

Abstract:

Objective To summarize the clinical manifestation and colonoscopic characteristics of AIDS patients complicated with digestive symptoms lesion, then improve the understanding of AIDS patients with digestive diseases.Methods We collect and analyzed the clinical data of 109 confirmed human immunodeficiency virus (HIV) patients and 116 HIV-negative patients underwent colonoscopy from January 2013 to October 2019, then compare the clinical manifestations and colonoscopy characteristics of HIV infected (experimental group) and HIV negative patients (control group). At the same time, HIV infected people were divided into two groups according to CD4⁺ T lymphocyte count for control analysis, with group A of 34 cases (CD4⁺ cells >200×10⁶/L), group B of 75 cases (CD4⁺ cells < 200×10⁶/L).Results The detection rate of colorectal ulcer and overall pathological changes under colonocopy in experiment group was significantly higher than that in control group. The difference was statistically significant (P <0.05). The detection rate of congestion and erosion of intestinal mucosa and overall pathological changes in group B was significantly higher than that in group A, the difference was statistically significant (P < 0.05).Conclusion AIDS patients are more likely to develop colorectal ulcer than the general population, with the decrease of CD4⁺ cell count, the incidence of intestinal inflammatory lesion and the overall lesion of intestinal diseases increased.