艾滋病合并肝泡型棘球蚴感染1例并文献复习

摘要

Objective To analyze the difficulties in the diagnosis and the reason of rapid progress of acquired immunodeficiency syndrome (AIDS) patients complicated with hepatocellular echinococcosis infection.Methods The clinical data of 1 patient with AIDS complicated with hepatic alveolar echinococcosis admitted to Beijing You'an Hospital was analyzed retrospectively.The clinical data including the disease history,epidemiological history,laboratory examination,imaging examination and pathological examination,etc.,to analyze the characteristics of the disease and diagnosis and treatment through,discuss the difficulties in the diagnosis and treatment process,and finally review the literature and review the characteristics of the disease of HepatocellularEchinococcosis infection.Results In this case,the epidemiological history is about one and a half years,with giant echinococcosis changes in liver,and it's thought that the cellular and humoral immune defect caused by human immunodeficiency vincs (HIV) infection might be the major reason of the acute development and early manifestations of hepatic alveolar echinococcosis.Conclusion The patients with AIDS,who come from epidemic areas of echinococcosis epidemic area,even in the case of negative serum immunology,the diagnosis of echinococcosis for intrahepatic tumor-like lesions should also be considered.%目的 分析艾滋病患者合并肝泡型棘球蚴感染诊断困难点及快速进展原因.方法 回顾性分析首都医科大学附属北京佑安医院收治的1例艾滋病合并肝泡型棘球蚴感染患者临床资料,包括起病史、流行病学史、实验室检查、影像学检查及病理检查等,分析疾病特点及诊疗经过,讨论诊治过程中的难点,最终联合文献复习系统回顾肝泡型棘球蚴疾病特点.结果 本病例中患者流行病学史1年半,肝脏出现巨型棘球蚴改变,考虑艾滋病感染人类免疫缺陷病毒引起的细胞和体液免疫缺陷可能是造成肝泡型棘球蚴急性发展和早期表现的主要原因.结论 诊断艾滋病的患者,有棘球蚴流行病区居留史,即使在血清免疫学检查阴性的情况下,肝内肿瘤样病变也应考虑棘球蚴的诊断可能.