Bard M, Couderc L J, Saimot A G, Scherrer A, Frachon I, Seigneur F, Caubarrere I
Service de Pneumologie, Hôpital Foch, Suresnes, France.
Eur Respir J. 1998 Mar;11(3):771-5.
Human immunodeficiency virus (HIV) infection has been associated with a wide spectrum of pulmonary disease. We report three HIV-seropositive patients with rapidly worsening airway obstruction associated with bronchiectasis. All subjects (age range 33-39 yrs) were cigarette smokers. Two had previously used intravenous drugs. The CD4 lymphocyte count ranged 40-250 cells x mm(-3). All individuals had complained of increasing dyspnoea for 3-6 months. Within 1 yr, they all developed severe airway obstruction with a decrease in both forced expiratory volume in one second (FEV1) and ratio of FEV1 to forced vital capacity (FEV1/FVC) to less than 60% of predicted value, and a decrease in mean forced expiratory flow at 25-75% of the forced vital capacity (FEF25-75) to less than 35% of predicted value. Computed tomography of the chest disclosed bilateral dilated and thickened bronchi. No classical causes of genetic or acquired bronchiectasis were identified in our patients. Recurrent bacterial bronchitis occurred in the follow-up period of the three patients. In conclusion, unusually rapid airway obstruction associated with bronchiectasis should be added to the wide spectrum of respiratory complications of human immunodeficiency virus infection.
人类免疫缺陷病毒（HIV）感染与多种肺部疾病有关。我们报告了3例HIV血清学阳性患者，他们患有与支气管扩张相关的迅速加重的气道阻塞。所有受试者（年龄范围33 - 39岁）均为吸烟者。其中2例曾使用过静脉注射毒品。CD4淋巴细胞计数范围为40 - 250个细胞×mm⁻³。所有患者均主诉呼吸困难加重3 - 6个月。在1年内，他们均出现严重气道阻塞，一秒用力呼气容积（FEV1）以及FEV1与用力肺活量之比（FEV1/FVC）均降至预测值的60%以下，且用力肺活量25% - 75%时的平均用力呼气流量（FEF25 - 75）降至预测值的35%以下。胸部计算机断层扫描显示双侧支气管扩张和增厚。在我们的患者中未发现遗传性或获得性支气管扩张的典型病因。3例患者在随访期间均发生了复发性细菌性支气管炎。总之，与支气管扩张相关的异常快速气道阻塞应被纳入人类免疫缺陷病毒感染广泛的呼吸并发症之中。
