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[西非36例HIV感染患者的血栓栓塞表现]

[Thromboembolic manifestations in 36 HIV-infected patients in West Africa].

作者信息

Ello Frédéric Nogbou, Bawe Lidaw Déassoua, Kouakou Gisèle Affoué, Mossou Chrysostome Melaine, Adama Doumbia, Kassi Alain N'douba, Mourtada Dine, Ehui Eboi, Tanon Aristophane, Konin Christophe, Aoussi François Eba, Kakou Aka Rigobert, Eholié Serge Paul

机构信息

Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.

Institut de Cardiologie d'Abidjan, Côte d'Ivoire.

出版信息

Pan Afr Med J. 2018 Dec 6;31:224. doi: 10.11604/pamj.2018.31.224.13774. eCollection 2018.

Abstract

In HIV-infected patients thromboembolic disease is a complication linked to heightened risk. In Ivory Coast no study has been conducted on HIV-infected patients treated in HIV Services. The aim of our study is to describe HIV-associated thromboembolic manifestations in patients treated or untreated with antiretroviral drugs whose data were collected in the Infectious and Tropical Diseases Service (ITDS). We conducted a retrospective study by reviewing the medical records of HIV-infected patients hospitalized with deep vein thrombosis (DVT), arterial thrombosis and/or pulmonary embolism over the period January 2005-July 2015. Diagnosis was based on Doppler ultrasound of vessels and/or on thoracic angioscanner. Diagnostic, therapeutic and evolutionary features of thromboembolic manifestations in these patients were analyzed. The medical records of 36 patients, including 23 women (64%), with a sex-ratio M/F of 0.57 and an average age of 43±12 years were selected. Deep venous thrombosis (DVT) was found in 26 (72.2%) patients, pulmonary embolism (PE) in 9 (25%) patients and arterial thrombosis in 1 patient (2.8%). DVT was unilateral in 81% of cases and predominantly left-sided in 77% of cases. PE was unilateral and right-sided in 100% of cases while arterial thrombosis was bilateral in 2.7% of cases. In patients with DVT, the femoral vein (39%) and the popliteal vein (35%) were most commonly affected by thrombosis. PE involved the pulmonary arteries in 77.8% of cases while arterial thrombosis involved the left and right internal carotid. The majority of patients was under antiretroviral treatment (69%). The most commonly associated opportunistic infections included oral candidiasis (31%) and tuberculosis (33%). Nine patients died (25%). This study highlights high rates of DVT in HIV-infected patients. Other studies are necessary to better understand the role of HIV in the occurrence of thromboembolic disease.

摘要

在艾滋病毒感染患者中,血栓栓塞性疾病是一种与风险增加相关的并发症。在科特迪瓦,尚未对在艾滋病毒服务机构接受治疗的艾滋病毒感染患者进行过研究。我们研究的目的是描述在感染性和热带病科(ITDS)收集数据的接受或未接受抗逆转录病毒药物治疗的患者中与艾滋病毒相关的血栓栓塞表现。我们通过回顾2005年1月至2015年7月期间因深静脉血栓形成(DVT)、动脉血栓形成和/或肺栓塞住院的艾滋病毒感染患者的病历进行了一项回顾性研究。诊断基于血管多普勒超声和/或胸部血管扫描仪。分析了这些患者血栓栓塞表现的诊断、治疗和演变特征。选择了36例患者的病历,其中包括23名女性(64%),男女比例为0.57,平均年龄为43±12岁。26例(72.2%)患者发现深静脉血栓形成(DVT),9例(25%)患者发现肺栓塞(PE),1例(2.8%)患者发现动脉血栓形成。DVT在81%的病例中为单侧,在77%的病例中主要为左侧。PE在100%的病例中为单侧且右侧,而动脉血栓形成在2.7%的病例中为双侧。在DVT患者中,股静脉(39%)和腘静脉(35%)最常受血栓影响。PE在77.8%的病例中累及肺动脉,而动脉血栓形成累及左右颈内动脉。大多数患者接受抗逆转录病毒治疗(69%)。最常见的相关机会性感染包括口腔念珠菌病(31%)和结核病(33%)。9例患者死亡(25%)。这项研究突出了艾滋病毒感染患者中DVT的高发生率。需要进行其他研究以更好地了解艾滋病毒在血栓栓塞性疾病发生中的作用。

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