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[人类免疫缺陷病毒相关卡波西肉瘤的诊断与治疗]

[Diagnosis and treatment of HIV-related Kaposi's sarcoma].

作者信息

Reyners A K L, Sprenger H G, Suurmeijer A J H, van der Graaf W T A

机构信息

Universitair Medisch Centrum, Groningen.

出版信息

Ned Tijdschr Geneeskd. 2006 Mar 18;150(11):589-93.

Abstract

A 42-year-old heterosexual man presented with bluish-purple spots on his skin and in his mouth cavity that had been present for a few months; a 48-year-old homosexual man had painful lymphadenopathy in the groins and left axilla. Both men appeared to have a Kaposi's sarcoma and to be HIV-positive. During highly active antiretroviral therapy (HAART) and radiotherapy or chemotherapy, both the AIDS parameters and the skin lesions improved. Kaposi's sarcoma is AIDS-defining in HIV-seropositive patients. Human herpesvirus-8 infection seems to play a role in the development of Kaposi's sarcoma. The incidence of Kaposi's sarcoma has declined since the introduction of HAART. Nowadays, Kaposi's sarcoma is frequently the presenting symptom of HIV-seropositivity. Patients present with purple cutaneous lesions and/or generalised lymphadenopathy. Visceral lesions are associated with a shorter median survival. The treatment of Kaposi's sarcoma is palliative, whereas immune restitution can lead to regression of the sarcoma.

摘要

一名42岁的异性恋男性出现皮肤和口腔内蓝紫色斑点,已持续数月;一名48岁的同性恋男性腹股沟和左腋窝有疼痛性淋巴结病。两名男性似乎都患有卡波西肉瘤且HIV检测呈阳性。在高效抗逆转录病毒疗法(HAART)以及放疗或化疗期间,艾滋病指标和皮肤病变均有所改善。在HIV血清阳性患者中,卡波西肉瘤是艾滋病的定义性疾病。人疱疹病毒8型感染似乎在卡波西肉瘤的发生中起作用。自HAART引入以来,卡波西肉瘤的发病率有所下降。如今,卡波西肉瘤常常是HIV血清阳性的首发症状。患者表现为紫色皮肤病变和/或全身性淋巴结病。内脏病变与较短的中位生存期相关。卡波西肉瘤的治疗是姑息性的,而免疫恢复可导致肉瘤消退。

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