云南省82例住院儿童HIV/AIDS临床特征分析

摘要

Objective To analyze the clinical characteristics of HIV/AIDS among hospitalized children in Yunnan Province. Methods A retrospective analysis was conducted by using the demographic data, epidemiological data, clinical symptoms and complications, laboratory examination and clinical outcomes of HIV/AIDS children hospitalized in Yunnan AIDS Care Center from January 2006 to December 2015. Results The enrolled 82 HIV/AIDS children included 47 boys and 35 girls, 77 cases (93.90%) of them were infected with HIV through the mother to child transmission. Sixty-two children with the laboratory confirmed HIV/AIDS aged 6 to 15 years (75.60%), 17 children aged 1 to 6 years (20.73%), and 3 cases aged less than 1 year (3.66%). Assessment of physical growth showed that 39 children (47.5%) had a lower body weight and height, substandard body height was more prevalent in all children. Forty-four children (53.66%) showed severe immunosuppression and 16 children (19.51%) showed moderate immunosuppression. The common clinical symptoms of the affected children were chronic or recurrent cough in 51 cases (62.19%), continued or repeated fever in 47 cases (57.32%), anemia in 43 cases (52.44%), and malnutrition in 40 cases (48.78%). The main opportunistic infections included bacterial pneumonia in 25 cases (30.49%), tuberculosis in 24 cases (29.27%) and thrush in 16 cases (19.51%), of which 38% children with two kinds or more opportunistic infections. After treatment, 77 cases were improved and 5 cases died. Conclusions HIV/AIDS infection route is mainly the mother-to-child transmission among hospitalized children in Yunnan Province, and it is very important to propose early diagnosis and early treatment for HIV/AIDS children due to obvious growth limitation, severe immunosuppression, diverse clinical symptoms, different disease progression and combined infection disease spectrum from HIV/AIDS adult patients.%目的 分析云南省住院儿童HIV/AIDS临床特点.方法 回顾性分析云南省艾滋病关爱中心2006年1月—2015年12月收治的HIV/AIDS患儿人口学资料、流行病学资料、临床表现及合并症、实验室检查、临床转归等.结果 82例HIV/AIDS患儿中,男47例,女35例.其中93.90%(77/82)通过母婴传播感染HIV.年龄为6~15岁占75.60%(62/82), 1~6岁占20.73%(17/82),1岁以下占3.66%(3/82).体格生长评价显示,39例(47.56%)患儿的身高或体质量处于下等,所有患儿身高不达标更为常见.免疫功能重度抑制者44例(53.66%),中度抑制者16例(19.51%).该组患儿常见的临床表现为慢性或反复咳嗽51例(62.19%),持续或反复发热 47例(57.32%),贫血43例 (52.44%),营养不良40例(48.78%)等.主要机会性感染诊断:细菌性肺炎25例(30.49%),结核24例(29.27%),鹅口疮16例 (19.51%),其中38%的患儿合并有2种及2种以上机会性感染.治疗后好转77例,未愈死亡5例.结论 云南省住院儿童 HIV/AIDS感染途径以母婴传播为主, 患儿生长发育明显受限,免疫功能严重损害,临床表现复杂多样,疾病进展及合并感染疾病谱与HIV/AIDS成人患者有异,儿童HIV/AIDS早诊断、早治疗十分重要.