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目的回顾性分析广州八院收治的汉族艾滋病相关性卡波西肉瘤病人的临床、病理特点及诊治情况,总结其临床特点和诊治经验。方法回顾性分析2007年1月至2013年1月住院诊治的11例汉族艾滋病相关性卡波西肉瘤病人的临床资料。结果 111例卡波西肉瘤病人中男性10例(90.9%),中位年龄31岁(25~38岁),治疗前CD+4T淋巴细胞计数中位数47个/μL(9~497个/μL);2所有病人均合并有感染,其中72.7%为肺部感染,6例病人存在2种及以上机会性感染;3所有病人均有皮肤损害,其中4例起始于下肢,其他还包括颌下、躯干、腹股沟、足底、鼻梁、手指(各1例);1例女性病人以阴唇为首发皮损部位;4病理分型以斑点型(4例)和结节性(5例)为主;511例病人中有3例在发现卡波西肉瘤前已启动抗病毒治疗(ART),经过ART后病人病情均好转;余8例在发现卡波西肉瘤后启动ART,其中6例病人因合并多种机会性感染或播散至内脏(3例)死亡,另外2例经治疗后好转。结论汉族人艾滋病相关性卡波西肉瘤好发于中青年男性,病人基础免疫功能低下,均有不同程度的皮损表现,多数并发机会性感染,病理分型以斑点型和结节性多见,尽早ART有助于改善预后。
Objective To retrospectively analyze the clinical and pathological features, diagnosis and treatment of AIDS-related Kaposi’s sarcoma in Han nationality admitted in Guangzhou eight homes, and to summarize its clinical features and diagnosis and treatment experience. Methods The clinical data of 11 Han Chinese patients with Kaposi’s sarcoma who were admitted to hospital from January 2007 to January 2013 were analyzed retrospectively. Results Among the 111 cases of Kaposi’s sarcoma, 10 (90.9%) were males, with a median age of 31 years (range 25-38 years). Before treatment, the median of CD4 + T lymphocyte count was 47 / μL (9-497 / μL); 2 All patients were associated with infection, of which 72.7% were pulmonary infections and 6 patients had 2 or more opportunistic infections; 3 All patients had skin lesions, of which 4 started in the lower limbs and others included 1 case of female patients with labia as the first lesion site; 4 pathological type to spot type (n = 4) and nodular (5 cases) ; Of the 511 patients, 3 patients had antiviral therapy (ART) before the discovery of Kaposi’s sarcoma, and the patient’s condition improved after ART; the other 8 patients started ART after finding Kaposi’s sarcoma, of which 6 Patients with multiple opportunistic infections or disseminated to the internal organs (3 cases) died, the other 2 cases improved after treatment. Conclusions The AIDS-related Kaposi’s sarcoma in Han nationality mainly occurs in young and middle-aged males. The basic immune function of patients is poor. All of them have different degrees of skin lesions. Most of them are opportunistic infections. The pathological type is more common with spots and nodules As soon as ART helps to improve the prognosis.