McGowan I, Hawkins A S, Weller I V
Academic Department of Genito-Urinary Medicine, University College London Medical School, UK.
AIDS. 1993 Mar;7(3):349-54. doi: 10.1097/00002030-199303000-00007.
To determine the natural history of cryptosporidial infection in HIV-infected individuals.
Retrospective study.
University teaching hospital HIV inpatient and outpatient unit.
Thirty-eight HIV-infected patients presenting with cryptosporidial diarrhoea between April 1986 and July 1991 were identified retrospectively from laboratory records.
Eleven of the 38 patients had a clinical remission of their diarrhoea. Median lymphocyte count of the remission group was significantly higher than that of the non-remission group (1100 and 550 x 10(6)/l, respectively; P = 0.003). Median survival times were 66 and 11.5 weeks for the remission and non-remission groups, respectively (P = 0.001). Liver function tests performed at the initial diagnosis of cryptosporidial diarrhoea were available for 28 patients. Aspartate transaminase was raised in 16 and alkaline phosphatase in 10 of these 28 patients. Ten patients showed evidence of AIDS-associated sclerosing cholangitis, one patient had an episode of acute pancreatitis and another presented with acute cholecystitis.
This study suggests that HIV-associated cryptosporidial diarrhoea does not have a uniformly poor prognosis. Eleven out of 38 patients had a spontaneous clinical remission, which appears to be predicted by the absolute lymphocyte count. Abnormal liver function tests and hepatobiliary disease were common.
确定HIV感染个体中隐孢子虫感染的自然病程。
回顾性研究。
大学教学医院的HIV住院和门诊科室。
从实验室记录中回顾性识别出1986年4月至1991年7月间38例因隐孢子虫腹泻就诊的HIV感染患者。
38例患者中有11例腹泻临床缓解。缓解组的淋巴细胞计数中位数显著高于未缓解组（分别为1100和550×10⁶/L；P = 0.003）。缓解组和未缓解组的中位生存时间分别为66周和ll.5周（P = 0.001）。28例患者在隐孢子虫腹泻初诊时进行了肝功能检查。这28例患者中16例天冬氨酸转氨酶升高，10例碱性磷酸酶升高。10例患者有艾滋病相关硬化性胆管炎的证据，1例患者发生急性胰腺炎，另1例患者出现急性胆囊炎。
本研究提示，HIV相关隐孢子虫腹泻的预后并非一律很差。38例患者中有11例临床症状自发缓解，这似乎可由绝对淋巴细胞计数预测。肝功能检查异常和肝胆疾病很常见。
