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新疆地区80例获得性免疫缺陷综合征相关卡波西肉瘤的临床特征及不同治疗方法对预后的影响

The clinical characteristics of 80 cases of acquired immunodeficiency syndrome-associated Kaposi's sarcoma in Xinjiang Autonomous Region and the effect of different treatments on the prognosis.

作者信息

Yang Tongtong, He Li, Wan Xuefeng, Maimaitiaili Wubuli, Song Yuxia, Zhang Yuexin, Lu Xiaobo

机构信息

Department of Infectious Diseases, Sixth People's Hospital of Xinjiang Urumqi, P. R. China.

Department of Infectious Diseases, The First Teaching Hospital of Xinjiang Medical University Urumqi, P. R. China.

出版信息

Int J Clin Exp Med. 2015 Oct 15;8(10):18697-704. eCollection 2015.

Abstract

To analyze the clinical features of AIDS-related Kaposi's sarcoma (AIDS-KS) patients in Xinjiang Autonomous Region and the impact of CD4 (+)T lymphocyte count, highly active antiretroviral therapy (HAART) and systemic chemotherapy on the prognosis. The clinical information of 80 AIDS-KS patients admitted in Sixth People's Hospital of Xinjiang Autonomous Region from January 2008 to August 2014 was retrospectively reviewed. Population characteristics, extent of lesions, KS progress, CD4 (+)T lymphocyte count, combined opportunistic infections, treatment and prognosis of these patients were analyzed. The 80 patients were divided into five groups according to treatment methods, including HAART, HAART + chemotherapy, chemotherapy + HAART, chemotherapy, and untreated groups. The efficacy and prognosis of the five groups were compared. Among the 80 patients, 74 (92.50%) patients were Uygur. The average age was 39.5±9.9 years and male-to-female ratio was 3:1. The median of baseline CD4 (+)T lymphocyte count was 152.5 cells/μL and the interquartile was 233.25 cells/μL. CD4 (+)T lymphocyte counts were significantly increased after treatment in HAART, HAART + chemotherapy, and chemotherapy + HAART groups (P < 0.05). CD4 (+)T lymphocyte count in chemotherapy groups was significantly reduced after treatment (P < 0.05). The untreated group had the highest mortality rate (33.3%). In HAART group, KS-associated immune reconstitution inflammatory response syndrome (KS-IRIS) appeared in 45.5% cases and 2 death cases were caused by KS-IRIS. In Xinjiang Autonomous Region, the incidence of AIDS-KS is high in young Uygur male people. HAART followed by chemotherapy has ideal efficacy, reduces the incidence of KS-IRIS and improves the prognosis.

摘要

分析新疆地区艾滋病相关卡波西肉瘤(AIDS-KS)患者的临床特征以及CD4(+)T淋巴细胞计数、高效抗逆转录病毒治疗(HAART)和全身化疗对预后的影响。回顾性分析2008年1月至2014年8月在新疆维吾尔自治区第六人民医院收治的80例AIDS-KS患者的临床资料。分析这些患者的人口学特征、病变范围、KS进展情况、CD4(+)T淋巴细胞计数、合并机会性感染情况、治疗方法及预后。根据治疗方法将80例患者分为五组,包括HAART组、HAART+化疗组、化疗+HAART组、化疗组和未治疗组。比较五组的疗效及预后。80例患者中,维吾尔族74例(92.50%)。平均年龄39.5±9.9岁,男女比例为3∶1。基线CD4(+)T淋巴细胞计数中位数为152.5个/μL,四分位数间距为233.25个/μL。HAART组、HAART+化疗组和化疗+HAART组治疗后CD4(+)T淋巴细胞计数显著升高(P<0.05)。化疗组治疗后CD4(+)T淋巴细胞计数显著降低(P<0.05)。未治疗组死亡率最高(33.3%)。HAART组中,45.5%的病例出现KS相关免疫重建炎症反应综合征(KS-IRIS),2例死亡病例由KS-IRIS导致。在新疆地区,年轻维吾尔族男性AIDS-KS发病率高。HAART序贯化疗疗效理想,可降低KS-IRIS发生率,改善预后。

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Immune reconstitution inflammatory syndrome of Kaposi's sarcoma in an HIV-infected patient.艾滋病患者卡波西肉瘤免疫重建炎症综合征。
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