中华皮肤科杂志 ›› 2004, Vol. 37 ›› Issue (5): 256-258.

• 论著 • 上一篇    下一篇

HIV/AIDS患者口咽部念珠菌病与CD4+、CD8+T淋巴细胞分析

徐斌1, 董培玲1, 李若瑜2, 王爱平2, 余进2, 万喆2   

  1. 1. 首都医科大学北京佑安医院, 北京100054;
    2. 北京大学第一医院皮肤性病科
  • 收稿日期:2003-05-08 出版日期:2004-05-15 发布日期:2004-05-15

Clinical Features and CD4+/CD8+ T Lymphocytes in HIV/AIDS Patients with Oropharyngeal Candidiasis

XU Bin1, DONG Pei-ling1, LI Ruo-yu2, WANG Ai-ping2, YU Jin2, WAN Zhe2   

  1. Beijing Youan Hospital, Capital Medical University, Beijing 100054, China
  • Received:2003-05-08 Online:2004-05-15 Published:2004-05-15

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摘要： 目的 研究HIV/AIDS患者的口咽部念珠菌病的发病特点,CD4+计数、CD8+计数、CD4+/CD8+比值的分布特点,以及抗真菌治疗的特点。方法 观察20例合并口咽部念珠菌病的HIV/AIDS患者和对照组口腔病损情况,病损部行真菌镜检和真菌培养,外周血流式细胞仪检测CD4+、CD8+计数。研究组和对照组伊曲康唑治疗第1周、第2周、疗程结束时、停药后两周真菌学疗效比较。结果 19例为白念珠菌感染,1例为近平滑念珠菌感染。20例艾滋病患者可见舌部感染6例,口腔侧壁感染14例。CD4+、CD8+计数和CD4+/CD8+比值分别在119.40±127.43、652.50±338.57和0.163±0.130范围。伊曲康唑治疗HIV/AIDS组第1周、第2周、疗程结束时、停药后两周真菌清除率分别为16.67%、50.00%、61.11%、66.67%。结论 HIV/AIDS患者口咽部念珠菌感染的最常见致病菌是白念珠菌,最常见靶部位是舌和口腔侧壁。HIV/AIDS患者的口咽部念珠菌病抗真菌疗效与免疫状态有关。

关键词: HIV感染, 获得性免疫缺陷综合征, 念珠菌病,口腔

Abstract: Objective To study the clinical characteristics, the laboratory profile (CD4+ and CD8+ counts and CD4+/CD8+ ratio) and the efficacy of antifungal treatment in HIV/AIDS patients with oropharyngeal candidiasis. Methods Oral lesions were evaluated among 20 HIV/AIDS patients with oropharyngeal candidiasis and the controls who were HIV-negative patients with oropharyngeal candidiasis. Samples were obtained from the lesions for fungal examination by microscopy and culture. The flow cytometry was used for detection of CD4+ and CD8+ counts in peripheral blood. Treatment efficacy of itraconazole was assessed among study group and the control group after treatment for one week, two weeks, at the end of treatment, as well as two weeks after treatment. Results Out of 20 HIV/AIDS patients, 19 were infected with Candida albicans and one with Candida parapsilosis. Six cases had infection on the tongue and 14 on the mucous membrane of oral cavity. CD4+ and CD8+ counts, and CD4/CD8 ratio were 119.40±127.43, 652.50±338.57 and 0.163±0.13, respectively. Mycologic clearance rates were 16.67%, 50.00%, 61.11% and 66.67%, respectively, after treatment with itraconazole for one week, two weeks, at the end of treatment, and two weeks after treatment. Conclusions Oropharyngeal candidiasis is a complication occurred in HIV/AIDS patients, and Candida albicans is the most common pathogen of the infection. The tongue and mucous membrane of oral cavity are usually involved in the patients. The therapeutic efficacy is related to the status of immunity.

Key words: HIV infections, Acquired immunodeficiency syndrome, Candidiasis, oral