O'Keefe E A, Wood R, Van Zyl A, Cariem A K
Dept. of Medicine, University of Cape Town, Somerset Hospital, Greenpoint, South Africa.
Scand J Gastroenterol. 1998 Feb;33(2):212-7. doi: 10.1080/00365529850166978.
Abdominal pain in acquired immunodeficiency syndrome (AIDS) patients is often a marker of an underlying opportunistic pathologic condition. There are no data on HIV-related abdominal pain in Africa.
Forty-four consecutive Cape Town patients with advanced human immunodeficiency virus (HIV) infection (CD4 < 200) and abdominal pain were studied prospectively to determine aetiology and survival.
A probable cause of pain was identified in 37 (84%): disseminated Mycobacterium tuberculosis infection in 11, cryptosporidiosis in 6, cytomegalovirus infection in 6, and atypical mycobacterial infection in 2. Gastrointestinal lymphoma and pancreatitis were not seen. Fever, hepatomegaly, respiratory symptoms, abnormal chest radiograph, and adenopathy, ascites, or abscesses on ultrasound had predictive diagnostic value for disseminated M. tuberculosis. Fifty-one per cent of abdominal pain patients survived 6 months, compared with 73% of all AIDS patients (P < 0.001).
The aetiology of HIV-related abdominal pain in Cape Town reflects the high local prevalence of tuberculosis. Clinical and ultrasound features facilitate diagnosis. Abdominal pain is associated with poor survival.
获得性免疫缺陷综合征（艾滋病）患者的腹痛通常是潜在机会性病理状况的一个标志。在非洲，尚无关于与人类免疫缺陷病毒（HIV）相关腹痛的数据。
对连续44例开普敦晚期人类免疫缺陷病毒（HIV）感染（CD4＜200）且有腹痛症状的患者进行前瞻性研究，以确定病因和生存率。
37例（84%）患者的疼痛病因得以确定：11例为播散性结核分枝杆菌感染，6例为隐孢子虫病，6例为巨细胞病毒感染，2例为非典型分枝杆菌感染。未发现胃肠道淋巴瘤和胰腺炎。发热、肝肿大、呼吸道症状、胸部X线片异常以及超声检查发现淋巴结病、腹水或脓肿对播散性结核分枝杆菌感染具有预测诊断价值。腹痛患者中有51%存活6个月，而所有艾滋病患者的这一比例为73%（P＜0.001）。
开普敦与HIV相关腹痛的病因反映了当地结核病的高患病率。临床和超声特征有助于诊断。腹痛与生存率低相关。
