云南地区50岁及以上HIV感染者口腔损害流行情况分析
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摘要
目的:了解云南地区50岁及以上中老年HIV感染者口腔损害发病特征。方法:对2013-01～2016-12到昆明市第三人民医院感染一科就诊的315名50岁及以上HIV感染患者进行了口腔黏膜损害发病情况的横断面调查,并分析了该口腔损害与CD4计数水平的关系。结果:在185例(58. 73%)中共检出13种口腔黏膜损害,检出率最高的是念珠菌病122例(38. 73%),其中伪膜型68例(21. 59%)、红斑型52例(16. 51%)、口角炎18例(5. 71%);次位为毛状白斑25例(7. 94%),以后依次为复发性口腔溃疡20例(6. 35%)、沟纹舌17例(5. 40%)、单纯疱疹11例(3. 49%),41例(13. 02%)和1例(0. 32%)患者分别同时检出2种及3种病损。2种以上损害同时检出频率及口腔念珠菌病检出率与CD4计数水平有关。结论:老年HIV感染者口腔黏膜损害十分常见,以口腔念珠菌病为主。
Objective: To investigate the characteristics of oral lesions in HIV infected patients aged 50 years or older in Yunnan.Methods: 315 HIV infected patients aged 50 years and older from January 2013 to December 2016 were included in a cross-sectional survey at the Third People's Hospital of Kunming. The characteristics of oral mucosal lesions and the relationship between the oral lesions and CD4 count level were analyzed. Results: 13 kinds of oral mucosal lesion in 185 out of the 315 cases( 58. 73%) were observed. 122 cases were with candidiasis( 38. 73%),including 68( 21. 59%) of pseudomembranous type,52( 16. 51%) of erythema and 18( 5. 71%) of stomatitis; 25( 7. 94%) were with Hairy leukoplakia,20( 6. 35%) with recurrent oral ulcer,17( 5. 40%) with fissured tongue,11( 3. 49%) with herpes simplex. 2 and 3 lesions were detected in 41 cases( 13. 02%) and 1 case( 0. 32%),respectively. The rate of simultaneous detection of more than 2 lesions and the detection rate of oral candidiasis were related to the CD4 count level. Conclusion: Oral mucosal lesions are common in elderly patients with HIV infection,and oral candidiasis is the main type.
Objective: To investigate the characteristics of oral lesions in HIV infected patients aged 50 years or older in Yunnan.Methods: 315 HIV infected patients aged 50 years and older from January 2013 to December 2016 were included in a cross-sectional survey at the Third People's Hospital of Kunming. The characteristics of oral mucosal lesions and the relationship between the oral lesions and CD4 count level were analyzed. Results: 13 kinds of oral mucosal lesion in 185 out of the 315 cases( 58. 73%) were observed. 122 cases were with candidiasis( 38. 73%),including 68( 21. 59%) of pseudomembranous type,52( 16. 51%) of erythema and 18( 5. 71%) of stomatitis; 25( 7. 94%) were with Hairy leukoplakia,20( 6. 35%) with recurrent oral ulcer,17( 5. 40%) with fissured tongue,11( 3. 49%) with herpes simplex. 2 and 3 lesions were detected in 41 cases( 13. 02%) and 1 case( 0. 32%),respectively. The rate of simultaneous detection of more than 2 lesions and the detection rate of oral candidiasis were related to the CD4 count level. Conclusion: Oral mucosal lesions are common in elderly patients with HIV infection,and oral candidiasis is the main type.
引文
[1]李爱萍,李树村.老年HIV感染者/AIDS患者流行病学特征及诊治进展[J].医学综述,2016,22(22):4479-4482.
[2]Listed N.Classification and diagnostic criteria for oral lesions in HIV infection.EC-Clearinghouse on oral problems related to HIV infection and WHO collaborating centre on oral manifestations of the immunodeficiency virus[J].J Oral Pathol Med,1993,22(7):289-291.
[3]Cahill S,Valadéz R.Growing older with HIV/AIDS:New public health challenges[J].Am J Public Health,2013,103(3):e7-e15.
[4]朱义芳,王婷婷,李冬冬,等.综合医院老年人类免疫缺陷病毒感染者的流行病学特征分析[J].实用医院临床杂志,2016,13(1):32-34.
[5]李鲜丽,晁春梅,戴虹,等.老年HIV/AIDS患者的流行病学及临床特征分析[J].昆明医科大学学报,2012,(6):105-108.
[6]李文杰,侯启年,覃锐,等.张家界市永定区1995-2008年老年人艾滋病流行特点分析[J].热带医学杂志,2010,10(6):725-726.
[7]Sanadhya YK,Sanadhya S,Nagarajappa R,et al.Correlation between oral lesions and opportunistic infections among human immunodeficiency virus-infected individuals in Indian population[J].Int Marit Health,2014,65(3):124-130.
[8]Frimpong P,Amponsah EK,Abebrese J,et al.Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana[J].J Korean Assoc Oral Maxillofac Surg,2017,43(1):29-36.
[9]孙庆云,熊鸿燕,王林,等.老年HIV/AIDS住院患者48例流行病学及临床特征分析[J].中国皮肤性病学杂志,2011,25(4):286-288.
[10]Sharma G,Pai KM,Setty S,et al.Oral manifestations as predictors of immune suppression in a HIV-/AIDS-infected population in south India[J].Clin Oral Investig,2009,13(2):141-148.
[11]Molinari JA,Glick M.Infectious diseases.In:Greenberg MS,Glick M,editors.Burket's oral medicine,diagnosis and treatment 2003[M].10th ed.Ontario:BC Decker,Hamilton,2003:539-556.
[12]Nicolatou-Galitis O,Velegraki A,Paikos S,et al.Effect of PI-HAART on the prevalence of oral lesions in HIV-1 infected patients.A Greek study[J].Oral Dis,2004,10(3):145-150.
[13]Patton LL.Current strategies for prevention of oral manifestations of human immunodeficiency virus[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2016,121(1):29-38.
[14]翟维维,陈雷,白劲松,等.云南地区成年人类免疫缺陷病毒感染患者口腔毛状白斑发病情况分析[J].华西口腔医学杂志,2011,29(2):149-152.
[15]Tsang PC,Samaranayake LP.Oral manifestations of HIVinfection in a group of predominantly ethnic Chinese[J].JOral Pathol Med,1999,28(3):122-127.
[16]Ramírez-Amador V,Esquivel-Pedraza L,Sierra-Madero J,et al.The Changing Clinical Spectrum of Human Immunodeficiency Virus(HIV)-Related Oral Lesions in 1,000 Consecutive Patients:A 12-Year Study in a Referral Center in Mexico[J].Medicine(Baltimore),2003,82(1):39-50.
[2]Listed N.Classification and diagnostic criteria for oral lesions in HIV infection.EC-Clearinghouse on oral problems related to HIV infection and WHO collaborating centre on oral manifestations of the immunodeficiency virus[J].J Oral Pathol Med,1993,22(7):289-291.
[3]Cahill S,Valadéz R.Growing older with HIV/AIDS:New public health challenges[J].Am J Public Health,2013,103(3):e7-e15.
[4]朱义芳,王婷婷,李冬冬,等.综合医院老年人类免疫缺陷病毒感染者的流行病学特征分析[J].实用医院临床杂志,2016,13(1):32-34.
[5]李鲜丽,晁春梅,戴虹,等.老年HIV/AIDS患者的流行病学及临床特征分析[J].昆明医科大学学报,2012,(6):105-108.
[6]李文杰,侯启年,覃锐,等.张家界市永定区1995-2008年老年人艾滋病流行特点分析[J].热带医学杂志,2010,10(6):725-726.
[7]Sanadhya YK,Sanadhya S,Nagarajappa R,et al.Correlation between oral lesions and opportunistic infections among human immunodeficiency virus-infected individuals in Indian population[J].Int Marit Health,2014,65(3):124-130.
[8]Frimpong P,Amponsah EK,Abebrese J,et al.Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana[J].J Korean Assoc Oral Maxillofac Surg,2017,43(1):29-36.
[9]孙庆云,熊鸿燕,王林,等.老年HIV/AIDS住院患者48例流行病学及临床特征分析[J].中国皮肤性病学杂志,2011,25(4):286-288.
[10]Sharma G,Pai KM,Setty S,et al.Oral manifestations as predictors of immune suppression in a HIV-/AIDS-infected population in south India[J].Clin Oral Investig,2009,13(2):141-148.
[11]Molinari JA,Glick M.Infectious diseases.In:Greenberg MS,Glick M,editors.Burket's oral medicine,diagnosis and treatment 2003[M].10th ed.Ontario:BC Decker,Hamilton,2003:539-556.
[12]Nicolatou-Galitis O,Velegraki A,Paikos S,et al.Effect of PI-HAART on the prevalence of oral lesions in HIV-1 infected patients.A Greek study[J].Oral Dis,2004,10(3):145-150.
[13]Patton LL.Current strategies for prevention of oral manifestations of human immunodeficiency virus[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2016,121(1):29-38.
[14]翟维维,陈雷,白劲松,等.云南地区成年人类免疫缺陷病毒感染患者口腔毛状白斑发病情况分析[J].华西口腔医学杂志,2011,29(2):149-152.
[15]Tsang PC,Samaranayake LP.Oral manifestations of HIVinfection in a group of predominantly ethnic Chinese[J].JOral Pathol Med,1999,28(3):122-127.
[16]Ramírez-Amador V,Esquivel-Pedraza L,Sierra-Madero J,et al.The Changing Clinical Spectrum of Human Immunodeficiency Virus(HIV)-Related Oral Lesions in 1,000 Consecutive Patients:A 12-Year Study in a Referral Center in Mexico[J].Medicine(Baltimore),2003,82(1):39-50.