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目的探讨HIV/AIDS合并药疹住院患者的CD4~+T淋巴细胞水平与临床特征、实验室检查、转归及愈后的关系。方法收集本院47例住院HIV/AIDS合并药疹患者的临床资料,回顾性分析患者的一般资料、致敏药物、药疹类型、实验室检查及疾病转归情况,重点分析CD4~+计数<200个/μL组与CD4~+计数>200个/μL组的异同。结果 CD4~+计数<200个/μL组患者重症药疹发生率为48.28%,合并电解质紊乱的发生率为51.72%、合并感染率为62.07%,平均住院日为19.63天,皮疹消退时间为23.81天,死亡率为20.69%,而CD4~+计数>200个/μL组患者重症药疹的发生率为11.11%、合并电解质紊乱的发生率为22.22%、合并感染率为11.11%,平均住院日为11.52天,皮疹消退时间为17.32天,死亡率为5.56%,二者差异有统计学意义(P<0.05)。而二者在在肝功能受累、是否使用激素治疗情况差异无统计学意义(P>0.05)。继发感染引起的死亡占总死亡率的71.43%。结论 CD4~+计数<200个/μL组HIV/AIDS患者较CD4~+计数>200个/μL组HIV/AIDS患者重症药疹的发生率更高、更易合并电解质紊乱、感染,并且平均住院日与皮疹消退时间更长,死亡率更高;继发感染是主要死因,早期及时的对症治疗、防治继发感染很重要。
Objective To investigate the relationship between the level of CD4 ~ + T lymphocytes in hospitalized patients with HIV / AIDS and drug eruption, clinical features, laboratory tests, prognosis and prognosis. Methods The clinical data of 47 hospitalized HIV / AIDS patients with drug eruption were collected. The general data, allergenic drugs, drug eruptions, laboratory tests and disease outcomes were retrospectively analyzed. The focus was on the analysis of CD4 ~ + counts <200 / μL group and CD4 ~ + count> 200 / μL group similarities and differences. Results The incidence of severe drug eruption in patients with CD4 ~ + count <200 / μL was 48.28%. The incidence of combined electrolyte disturbance was 51.72%, the infection rate was 62.07%, the average length of hospital stay was 19.63 days and the rash subsidence time was 23.81 days , And the mortality rate was 20.69%. The incidence of severe drug eruption was 11.11% in patients with CD4 ~ + count> 200 cells / μL, the incidence of combined electrolyte disturbance was 22.22%, the infection rate was 11.11%, and the average length of stay was 11.52 Day, rash subsided time was 17.32 days, the mortality rate was 5.56%, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the involvement of hepatic function and hormone therapy (P> 0.05). Death from secondary infection accounted for 71.43% of the total mortality. Conclusion The incidence of severe drug eruption in HIV / AIDS patients with CD4 ~ + count <200 / μL group is higher than that of CD4 ~ + count> 200 cells / μL group. It is more likely to be associated with electrolyte imbalance and infection, and the average length of stay and Rash subsided longer, higher mortality; secondary infection is the leading cause of death, early and timely symptomatic treatment, prevention and treatment of secondary infection is very important.