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中国云南艾滋病病毒/艾滋病合并药疹患者的临床分析

Clinical analysis of HIV/AIDS patients with drug eruption in Yunnan, China.

作者信息

Li Yu-Ye, Jin Yong-Mei, He Li-Ping, Bai Jin-Song, Liu Jun, Yu Min, Chen Jian-Hua, Wen Jing, Kuang Yi-Qun

机构信息

Department of Dermatology and Venerology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, P. R. China.

Department of HIV/AIDS, The Third People's Hospital of Kunming, Kunming 650041, P. R. China.

出版信息

Sci Rep. 2016 Oct 31;6:35938. doi: 10.1038/srep35938.

Abstract

Drug eruption is the most common clinical presentation in patients with HIV/AIDS. The systemic clinical and risk factors associated with drug eruption remain unknown. A retrospective analysis in HIV/AIDS patients with drug eruption was carried out with demographic data, epidemiological data, clinical characteristics, laboratory data and follow-up data. The risk factors correlated with prognosis were assessed by case control analysis. A total of 134 out of 1817 HIV/AIDS patients (7.4%) presented drug eruptions. The major class of sensitizing drug was HAART drugs (47.7%), followed by antibiotics (47.0%). Nevirapine (39.6%) was the most common sensitizing drug in the HAART regimens. The patients received HAART or had allergic history were prone to develop drug eruption. The alanine aminotransferase, albumin, globulin, creatinine, blood urea nitrogen (BUN), lymphocytes, red blood cells (RBC) and eosinophils of the drug eruption patients were significantly different the control patients. The allergic history, opportunistic infection, viral load, CD4 cell count, high globulin and low albumin were the risk factors correlated with death in HIV/AIDS patients with drug eruption. It is proposed that patients with higher viral loads, higher globulin levels and lower white blood cells (WBC) should be given special attention for the prevention of complications and death.

摘要

药疹是人类免疫缺陷病毒/获得性免疫综合征(HIV/AIDS)患者最常见的临床表现。与药疹相关的全身临床症状和危险因素尚不清楚。对患有药疹的HIV/AIDS患者进行回顾性分析,收集其人口统计学数据、流行病学数据、临床特征、实验室数据和随访数据。通过病例对照分析评估与预后相关的危险因素。1817例HIV/AIDS患者中共有134例(7.4%)出现药疹。致敏药物的主要类别是高效抗逆转录病毒治疗(HAART)药物(47.7%),其次是抗生素(47.0%)。奈韦拉平(39.6%)是HAART方案中最常见的致敏药物。接受HAART治疗或有过敏史的患者容易发生药疹。药疹患者的丙氨酸转氨酶、白蛋白、球蛋白、肌酐、血尿素氮(BUN)、淋巴细胞、红细胞(RBC)和嗜酸性粒细胞与对照患者有显著差异。过敏史、机会性感染、病毒载量、CD4细胞计数、高球蛋白和低白蛋白是与患有药疹的HIV/AIDS患者死亡相关的危险因素。建议对病毒载量较高、球蛋白水平较高和白细胞(WBC)较低的患者给予特别关注,以预防并发症和死亡。

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