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目的探讨艾滋病(AIDS)病人艾滋病病毒(HIV)视网膜病变的发病特点及临床表现特征。方法回顾273例有眼底照片的AIDS病人的资料,分析85例有HIV视网膜病变病人的CD4+T淋巴细胞计数、棉絮斑部位及数量、出血部位、眼别等,探讨HIV视网膜病变的发病特点和临床表现。结果273例AIDS病人中,发现有HIV视网膜病变的85例,发病率为31.14%。单、双眼均可发病,主要表现为眼底棉絮斑,大多部分伴有出血,单纯出血和Roth斑较少。大多位于眼底后极部,可自行消退;HIV视网膜病变病人的CD4+T淋巴细胞计数小于200细胞/μl,86%的病人CD4+T淋巴细胞计数低于100细胞/μl,近50%的病人CD4+T淋巴细胞计数低于50细胞/μl;不同CD4+T淋巴细胞水平间患眼棉絮斑数量比较,差异无统计学意义;各水平间棉絮斑、出血构成比比较差异无统计学意义。结论AIDS病人视网膜病变主要表现为棉絮斑,出现在细胞免疫水平较低的病人。随着免疫功能降低而发病率增加。AIDS病人应做常规眼科检查。
Objective To investigate the incidence and clinical features of AIDS patients with HIV. Methods The data of 273 cases of AIDS patients with fundus photographs were retrospectively analyzed. The counts of CD4 + T lymphocytes in 85 patients with HIV retinopathy, the location and quantity of cotton wool spots, the bleeding sites and the number of eyes were analyzed to explore the characteristics of HIV retinopathy Clinical manifestations. Results Among 273 AIDS patients, 85 cases of HIV retinopathy were found, the incidence was 31.14%. Single and binocular can be the disease, mainly manifested as eye fundus cotton spot, most of the associated with bleeding, bleeding and Roth spot less. Mostly located in the posterior pole of the fundus, can self-resolution; HIV retinopathy in patients with CD4 + T lymphocyte count less than 200 cells / μl, 86% of patients with CD4 + T lymphocyte count less than 100 cells / μl, nearly 50% of patients The CD4 + T lymphocyte count was less than 50 cells / μl. There was no significant difference in the number of eyeballs between the different CD4 + T lymphocyte levels. There was no significant difference in the constituent ratio of cotton wool spot and hemorrhage between the different levels. Conclusion The main manifestations of retinopathy in AIDS patients are cotton wool spots, appearing in patients with low cellular immunity. The incidence increases as immune function decreases. AIDS patients should be routine ophthalmic examination.