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目的了解人类免疫缺陷病毒(HIV)感染者胃镜特点。方法选取2010年12月-2015年11月于北京佑安医院确诊HIV感染者胃镜结果及临床、病理资料,进行统计分析。结果 5年共行HIV感染者胃镜检查283例次,门诊124例(43.8%),住院159例(56.2%);男∶女约为7∶1;年龄(39.3±12.4)岁。CD4+T淋巴细胞计数(229.0±21.4)个/μl,<200个/μl有73例,接受高效抗反转录病毒治疗(HAART)221例(92.5%),幽门螺旋杆菌阳性率为26.8%。主诉症状中腹胀和上腹痛最常见,分别为32.2%(79/245)和22.9%(56/245),其次为胸痛、消化道出血、反酸或烧心、恶心或呕吐、吞咽困难等。胃镜主要表现为慢性非萎缩性胃炎30.2%(74/245)、反流性食管炎16.7%(41/245),其次为胆汁反流性胃炎、慢性萎缩性胃炎、胃溃疡、食管溃疡等。结合临床与病理明确诊断恶性肿瘤16例(6.5%),其中胃癌7例,卡波西肉瘤5例,非霍奇金淋巴瘤4例。机会性感染均发生在食管,真菌感染6例(2.4%),结核感染12例(4.9%),巨细胞病毒感染4例(1.6%)。结论 HIV感染者消化道症状并无特异性,但胃镜下异常病变(包括各种机会感染、恶性肿瘤等)检出率高,且症状与疾病严重程度并不一致,故对有症状者仍应尽可能行胃镜检查。
Objective To understand the characteristics of gastroscope in human immunodeficiency virus (HIV) infected persons. Methods The gastroscopy results and clinical and pathological data of HIV-infected persons in Beijing You’an Hospital from December 2010 to November 2015 were collected and analyzed statistically. Results A total of 283 HIV-infected patients were enrolled in this study. Among them, 124 (43.8%) were outpatients and 159 were hospitalized (56.2%). The male and female were 7 to 1 years old and 39.3 ± 12.4 years old respectively. CD4 + T lymphocyte count (229.0 ± 21.4) / μl, 73 cases with <200 cells / μl, 221 cases with HAART (92.5%), and H. pylori was 26.8% . The most common symptoms of abdominal distension and abdominal pain were the most common, 32.2% (79/245) and 22.9% (56/245) respectively, followed by chest pain, gastrointestinal bleeding, acid reflux or heartburn, nausea or vomiting, dysphagia and so on. Gastroscopy mainly showed 30.2% (74/245) of chronic non-atrophic gastritis and 16.7% (41/245) of reflux esophagitis, followed by bile reflux gastritis, chronic atrophic gastritis, gastric ulcer and esophageal ulcer. 16 cases (6.5%) were diagnosed with clinical and pathological diagnosis, including 7 cases of gastric cancer, 5 cases of Kaposi’s sarcoma and 4 cases of non-Hodgkin’s lymphoma. Opportunistic infections occurred in 6 cases (2.4%) of esophageal and fungal infections, 12 (4.9%) cases of tuberculosis and 4 cases (1.6%) of cytomegalovirus infections. Conclusion The gastrointestinal symptoms of HIV-infected persons are not specific, but the detection rate of abnormal lesions (including various opportunistic infections and malignant tumors) under endoscopy is high, and the symptoms and severity of the disease are not consistent. Therefore, Gastroscopy may be OK.