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目的探讨艾滋病患者食管及胃黏膜损害的病变特点。方法研究对象共240例,分为实验组及对照组。实验组包括133例有消化道症状的艾滋病患者,对照组为107例HIV抗体阴性者。实验组所有患者行胃镜检查,并取黏膜组织做光镜及电镜观察,另外使用Warthin-Starry染色判断幽门螺旋杆菌(Hp)感染。同时对镜下可疑病变的食管黏膜进行刷检以检测真菌孢子或者菌丝。对照组病例作以上的相同处理。结果两组间慢性胃炎的发生率未发现差异;实验组133例中有21例检出念珠菌性食管炎。实验组中消化性溃疡(PU)及Hp的检出率(分别为2.26%和19.55%)较对照组为低(分别为21.49%和54.21%),(P<0.005)。胃镜或显微镜下观察,实验组黏膜损害严重。结论艾滋病患者易出现念珠菌性食管炎,消化性溃疡及幽门螺旋杆菌感染的发生率较对照组低,但显微镜下及电镜观察到的慢性胃炎黏膜细胞损伤均较对照组严重。原因可能与艾滋病患者一般CD4+T淋巴细胞计数较少有关。
Objective To investigate the pathological changes of esophageal and gastric mucosal lesions in AIDS patients. Methods A total of 240 subjects were divided into experimental group and control group. The experimental group consisted of 133 AIDS patients with gastrointestinal symptoms and 107 controls were negative for HIV antibody. All patients in the experimental group underwent gastroscopy, mucosal tissue taken light and electron microscopy, and Warthin-Starry staining to determine H. pylori (Hp) infection. At the same time, suspicious lesions of the esophageal mucosa to brush test to detect fungal spores or mycelium. Control group of patients for the same treatment. Results There was no difference in the incidence of chronic gastritis between the two groups. Candida esophagitis was detected in 21 of 133 patients in the experimental group. The detection rate of peptic ulcer (PU) and Hp in the experimental group (2.26% and 19.55% respectively) was lower than that in the control group (21.49% and 54.21% respectively) (P <0.005). Gastroscopy or microscopic observation, the experimental group mucosal damage. Conclusions The prevalence of Candida esophagitis, peptic ulcer and Helicobacter pylori in AIDS-causing patients is lower than that in the control group. However, the damage of chronic gastritis mucosal cells under microscope and electron microscope is more serious than that of the control group. The reason may be AIDS patients generally CD4 + T lymphocyte count less relevant.