Diaz P T, King M A, Pacht E R, Wewers M D, Gadek J E, Nagaraja H N, Drake J, Clanton T L
Department of Internal Medicine, Ohio State University, Columbus 43210, USA.
Ann Intern Med. 2000 Mar 7;132(5):369-72. doi: 10.7326/0003-4819-132-5-200003070-00006.
Previous uncontrolled reports have suggested that HIV-seropositive persons develop an accelerated form of emphysema.
To characterize the risk for emphysema in a stable HIV-seropositive outpatient population.
Controlled, cross-sectional analysis.
Midwestern urban community.
HIV-seropositive persons (n = 114) without AIDS-related pulmonary complications and HIV-seronegative controls (n = 44), matched for age and smoking history.
Measurement of pulmonary function, bronchoalveolar lavage, and high-resolution computed tomography of the chest.
The incidence of emphysema was 15% (17 of 114) in the HIV-seropositive group compared with 2% (1 of 44) in the HIV-seronegative group (P = 0.025). The incidence of emphysema in participants with a smoking history of 12 pack-years or greater was 37% (14 of 38 persons) in the HIV-seropositive group compared with 0% (0 of 14 persons) in the HIV-seronegative group (P = 0.011). The percentage of cytotoxic lymphocytes in lavage fluid was much higher in HIV-seropositive smokers with emphysema.
Infection with HIV accelerates the onset of smoking-induced emphysema. The results of this study support the emerging concept that cytotoxic lymphocytes may have an important role in emphysema pathogenesis.
先前未经对照的报告提示，HIV血清反应阳性者会出现一种加速型肺气肿。
明确稳定的HIV血清反应阳性门诊患者发生肺气肿的风险。
对照横断面分析。
中西部城市社区。
无艾滋病相关肺部并发症的HIV血清反应阳性者（n = 114）和HIV血清反应阴性对照者（n = 44），按年龄和吸烟史匹配。
肺功能测定、支气管肺泡灌洗以及胸部高分辨率计算机断层扫描。
HIV血清反应阳性组肺气肿发生率为15%（114例中的17例），而HIV血清反应阴性组为2%（44例中的1例）（P = 0.025）。吸烟史达12包年或更长的参与者中，HIV血清反应阳性组肺气肿发生率为37%（38人中的14人），而HIV血清反应阴性组为0%（14人中的0人）（P = 0.011）。有肺气肿的HIV血清反应阳性吸烟者灌洗液中细胞毒性淋巴细胞的百分比要高得多。
HIV感染会加速吸烟所致肺气肿的发病。本研究结果支持了细胞毒性淋巴细胞可能在肺气肿发病机制中起重要作用这一新兴概念。
