Fong I W, Toma E
St. Michael's Hospital, University of Toronto, Ontario, Canada.
Clin Infect Dis. 1995 May;20(5):1305-10. doi: 10.1093/clinids/20.5.1305.
Progressive multifocal leukoencephalopathy (PML) is usually a fatal neurological disease. The natural history of PML in patients with human immunodeficiency virus infection was analyzed. The correlations between CD4+ lymphocyte count, previous diagnosis of AIDS, treatment with cytarabine, and survival time are reported for 28 individuals for whom the diagnosis of PML was confirmed by histopathologic examination. For 16 patients (57%), PML was the AIDS-defining illness. For these 16 patients, the mean (+/- SD) survival time after presentation was 7.5 +/- 7.6 months (range, 1-31 months), whereas that for the 12 patients (43%) for whom AIDS was previously diagnosed was 3.2 +/- 2.8 months (range, 1-11 months) (P = .01). The overall mean (+/- SD) CD4+ cell count was 85 +/- 82/mm3 (range, 12-349/mm3). The mean (+/- SD) survival time for patients with CD4+ cell counts of > or = 90/mm3 at the time of presentation was 9.4 +/- 8.7 months, while that for patients with CD4+ cell counts of < 90/mm3 at the time of presentation was 3.6 +/- 1.8 months (P = .03). The nine patients did not benefit from treatment with cytarabine.
进行性多灶性白质脑病（PML）通常是一种致命的神经系统疾病。对人类免疫缺陷病毒感染患者中PML的自然病程进行了分析。报告了28例经组织病理学检查确诊为PML的患者的CD4 +淋巴细胞计数、既往艾滋病诊断、阿糖胞苷治疗与生存时间之间的相关性。对于16例患者（57%），PML是艾滋病定义疾病。对于这16例患者，出现症状后的平均（±标准差）生存时间为7.5±7.6个月（范围1 - 31个月），而对于先前已诊断为艾滋病的12例患者（43%），生存时间为3.2±2.8个月（范围1 - 11个月）（P = 0.01）。总体平均（±标准差）CD4 +细胞计数为85±82/mm³（范围12 - 349/mm³）。出现症状时CD4 +细胞计数≥90/mm³的患者的平均（±标准差）生存时间为9.4±8.7个月，而出现症状时CD4 +细胞计数＜90/mm³的患者的生存时间为3.6±1.8个月（P = 0.03）。9例患者未从阿糖胞苷治疗中获益。
