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目的分析艾滋病病毒(HIV)相关的精神疾病的患病率、临床特点、治疗及转归,为HIV相关的精神疾病病人的诊疗提供依据。方法对云南省传染病专科医院/艾滋病关爱中心2008年1月至2014年4月首次住院的HIV感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)及相关精神疾病的病人进行回顾分析。结果 3 921例HIV/AIDS住院病人中,HIV相关的精神疾病41例,患病率为1.05%;平均年龄(38.07±10.23)岁(31~40)岁,无业者19例(46.34%),静脉吸毒传播的21例(51.22%),异性性传播18例(43.90%),合并丙型肝炎17例(41.46%),合并乙型肝炎2例(4.88%)。41例HIV相关的精神病组病人中,20例有抑郁症,10例谵妄,9例痴呆,抑郁及躁狂双向表现者2例;其中21例有明显的自杀倾向,20例有妄想。41例均给予精神科药物治疗及抗病毒治疗(ART)和心理专科治疗。ART半年随访监测CD4~+T淋巴细胞计数平均增长120个/μL,病毒载量检测均低于检测下限。在ART过程中依然给以精神科药物维持治疗,给予心理疏导治疗,41例病人均未出现精神病发作现象。结论 HIV/AIDS病人中精神病患病率高,以青壮年为主,多合并静脉吸毒病史,临床上主要表现为抑郁症,通过抗病毒治疗和抗精神病药物治疗,大多数病人能有效控制病情。
Objective To analyze the prevalence, clinical features, treatment and prognosis of HIV-related mental illnesses and provide basis for the diagnosis and treatment of HIV-related mental illness patients. Methods A retrospective analysis was conducted on the first hospitalized HIV / AIDS patients (referred to as HIV / AIDS patients) and related mental diseases from January 2008 to April 2014 in Yunnan Infectious Disease Hospital / AIDS Care Center. Results Among the 3 921 inpatients with HIV / AIDS, 41 were HIV-related mental illnesses with a prevalence of 1.05%; mean age (38.07 ± 10.23) years (31-40) years old and 19 unemployed people (46.34%), Intravenous drug use was transmitted in 21 cases (51.22%), heterosexual transmission in 18 cases (43.90%), hepatitis C in 17 cases (41.46%) and hepatitis B in 2 cases (4.88%). Of the 41 cases of HIV-related psychiatric patients, 20 were depression, 10 delirium, 9 dementia, depression and manic two-way performance in 2 cases; 21 of them had obvious suicidal tendencies and 20 delusions. 41 cases were given psychiatric drug treatment and anti-virus treatment (ART) and psychological specialist treatment. ART 6 months follow-up monitoring of CD4 ~ + T lymphocyte count an average increase of 120 / μL, viral load detection were lower than the detection limit. In the process of ART is still to psychiatric drugs to maintain treatment, to give psychological counseling treatment, 41 patients did not appear psychosis. Conclusion The prevalence of psychosis in HIV / AIDS patients is high, mainly young and middle-aged, with the history of intravenous drug abuse. The main clinical manifestation is depression. Most patients can effectively control the disease through antiviral and antipsychotic drugs.