Ullrich R, Heise W, Bergs C, L'age M, Riecken E O, Zeitz M
Department of Medicine, Free University of Berlin, FRG.
Gut. 1992 Aug;33(8):1080-4. doi: 10.1136/gut.33.8.1080.
The correlation of gastrointestinal symptoms and infections in 186 consecutive patients with human immunodeficiency virus (HIV) infection undergoing diagnostic endoscopy (oesophagogastroduodenoscopy, n = 124; colonoscopy, n = 37; both, n = 25) was investigated. Biopsy and stool samples were examined for infective agents. Only weight loss (p = 0.003) and dysphagia (p = 0.027) were more common in patients at stage CDC IV compared with earlier stages. In three of 27 patients at stage II/III and in 93 of 159 patients at stage IV an infective agent was identified in stool or gastrointestinal biopsy specimen (p < 0.001). Cytomegalovirus (n = 35), Candida sp (n = 28), M avium complex (n = 10), and Cryptosporidium (eight) were the most frequent agents detected. At stage IV, diarrhoea was more frequent in infected compared with non-infected patients (p = 0.006); however, an infective agent was also found in 39 of 82 patients at stage IV without diarrhoea. The frequency of gastrointestinal symptoms was not consistently increased in patients harbouring specific infective agents compared with non-infected patients. Our findings indicate that the pathogenic relevance of a gastrointestinal infection in HIV infected patients has to be verified and indirectly support the existence of an HIV associated enteropathy.
对186例接受诊断性内镜检查（食管胃十二指肠镜检查，n = 124；结肠镜检查，n = 37；两者皆做，n = 25）的连续人类免疫缺陷病毒（HIV）感染患者的胃肠道症状与感染之间的相关性进行了研究。对活检和粪便样本进行感染因子检查。与早期阶段相比，只有体重减轻（p = 0.003）和吞咽困难（p = 0.027）在疾病控制中心（CDC）IV期患者中更为常见。在27例II/III期患者中有3例以及159例IV期患者中有93例在粪便或胃肠道活检标本中发现了感染因子（p < 0.001）。巨细胞病毒（n = 35）、念珠菌属（n = 28）、鸟分枝杆菌复合体（n = 10）和隐孢子虫（8例）是检测到的最常见病原体。在IV期，感染患者的腹泻比未感染患者更常见（p = 0.006）；然而，在82例IV期无腹泻的患者中也有39例发现了感染因子。与未感染患者相比，携带特定感染因子的患者胃肠道症状的发生率并未持续增加。我们的研究结果表明，HIV感染患者胃肠道感染的致病相关性必须得到证实，并且间接支持了HIV相关肠病的存在。
