Escamilla R, Pecoul J, Hermant C, Besombes J P, Krempf M
Service de Pneumologie et Allergologie, CHU Purpan, Toulouse.
Rev Mal Respir. 1992;9(4):425-9.
Both intravenous drug addiction (IVDA) and HIV infection can involve respiratory system. So, we have studied pulmonary function in 107 heroin abusers during deprivation to clarify the extent of these two factors respectively. Two groups were separated: 50 subjects without HIV infection (HIV-) and 57 seropositive subjects (HIV+) in early stage of the disease (mean CD4 lymphocytes: 457 +/- 61/mm3). 36 subjects have been investigated 6 months later to evaluate the reversibility of possible observed abnormalities. Altered pulmonary function was encountered similarly in HIV+ and HIV-. DLco was abnormal in 40% of cases both in HIV+ (mean DLco: 63.4 +/- 1.1% of predicted values) and HIV- (mean DLco: 65.4 +/- 1.5% pred); obstructive lung disease was present in 18% of HIV- (FEV1/VC: 63.8 +/- 2.5) and 9% of HIV+ (FEV1/VC: 61 +/- 3.6); restrictive lung disease was found more frequently (16% vs 10%) in HIV+ (FEV1/VC: 81.2 +/- 2.1, TLC: 72.4 +/- 3.6% pred) than in HIV- (FEV1/VC: 84.2 +/- 1.6, TLC: 71.2 +/- 0.9% pred). These abnormalities were not associated with significant arterial blood gas modifications. As a whole, DLco tend to improve in the two groups and this significantly for HIV+ (p less than 0.03). But for individuals initial DLco alteration was persistent in 68% of cases suggesting slow improvement. In conclusion, in this study HIV+ and HIV- IVDA were not different concerning pulmonary function. In this risk group, DLco itself had a poor specificity and only it follow-up may be of interest for pulmonary opportunistic infection screening.
静脉注射吸毒（IVDA）和艾滋病毒感染均可累及呼吸系统。因此，我们对107名海洛因滥用者在戒毒期间的肺功能进行了研究，以分别明确这两个因素的影响程度。研究分为两组：50名未感染艾滋病毒的受试者（HIV-）和57名疾病早期血清学阳性的受试者（HIV+）（平均CD4淋巴细胞计数：457±61/mm³）。6个月后对36名受试者进行了再次检查，以评估可能观察到的异常情况的可逆性。HIV+组和HIV-组出现肺功能改变的情况相似。HIV+组（平均一氧化碳弥散量：预测值的63.4±1.1%）和HIV-组（平均一氧化碳弥散量：预测值的65.4±1.5%）中均有40%的病例一氧化碳弥散量异常；HIV-组中有18%（第一秒用力呼气容积/肺活量：63.8±2.5）存在阻塞性肺疾病，HIV+组中有9%（第一秒用力呼气容积/肺活量：61±3.6）存在阻塞性肺疾病；HIV+组（第一秒用力呼气容积/肺活量：81.2±2.1，肺总量：预测值的72.4±3.6%）比HIV-组（第一秒用力呼气容积/肺活量：84.2±1.6，肺总量：预测值的71.2±0.9%）更频繁地出现限制性肺疾病（16%对10%）。这些异常与动脉血气的显著改变无关。总体而言，两组的一氧化碳弥散量均有改善趋势，HIV+组改善显著（p＜0.03）。但对于个体而言，68%的病例初始一氧化碳弥散量改变持续存在，提示改善缓慢。总之，在本研究中，HIV+和HIV-的静脉注射吸毒者在肺功能方面并无差异。在这个高危人群中，一氧化碳弥散量本身特异性较差，只有其随访结果可能对肺部机会性感染筛查有意义。
