MacPhail L A, Greenspan D, Feigal D W, Lennette E T, Greenspan J S
Department of Stomatology, University of California, San Francisco.
Oral Surg Oral Med Oral Pathol. 1991 Jun;71(6):678-83. doi: 10.1016/0030-4220(91)90273-f.
This study was conducted to characterize the recurrent aphthous ulcers (RAU) found in association with human immunodeficiency virus (HIV) infection, to examine evidence for increased severity of the ulcers with HIV disease, and to determine whether increased severity is associated with abnormalities of peripheral blood lymphocyte subsets. Seventy-five HIV-seropositive patients with RAU were followed for up to 2 years, and lymphocyte subsets were analyzed in 42. Minor, herpetiform, and major ulcer types were seen, but unexpectedly, 66% of the patients had the usually uncommon herpetiform and major types. These types were temporally associated with symptomatic HIV disease. Patients with major RAU were significantly more immunosuppressed than those with minor or herpetiform RAU in that they had fewer CD4 and CD8 lymphocytes (p less than 0.05). The lesion of RAU is considered to represent a local breakdown in immunoregulation. The systemic immune imbalance seen with HIV disease may amplify the local defect and lead to more severe ulcers.
本研究旨在对与人类免疫缺陷病毒（HIV）感染相关的复发性阿弗他溃疡（RAU）进行特征描述，检验溃疡严重程度随HIV疾病加重的证据，并确定严重程度增加是否与外周血淋巴细胞亚群异常有关。75例HIV血清学阳性且患有RAU的患者随访长达2年，对其中42例患者的淋巴细胞亚群进行了分析。观察到了轻型、疱疹样型和重型溃疡类型，但出乎意料的是，66%的患者患有通常不常见的疱疹样型和重型。这些类型在时间上与有症状的HIV疾病相关。重型RAU患者的免疫抑制程度明显高于轻型或疱疹样型RAU患者，因为他们的CD4和CD8淋巴细胞较少（p<0.05）。RAU病变被认为代表免疫调节的局部破坏。HIV疾病中出现的全身免疫失衡可能会放大局部缺陷并导致更严重的溃疡。
