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目的分析以带状疱疹为早期表现的HIV感染者的临床特点、治疗和预后,提高临床医生对本病的认识。方法回顾性分析2013年7月-2017年1月本科诊治的39例以带状疱疹为早期表现的HIV感染者的临床资料。结果 39例患者中,男∶女为4.57∶1(32∶7);平均年龄(51.54±15)岁,>50岁20例,20~50岁18例,15岁1例;71.79%(28/39)有明确冶游史;94.87%(37/39)患者皮损分布≥2支神经支配区,可伴大疱、血疱、脓疱及内脏损害等,神经痛也较明显;15.38%(6/39)患者CD4~+T淋巴细胞计数<500个/μL;56.41%(22/39)痊愈,43.59%(17/39)伴后遗神经痛,7.69%(3/39)复发,无死亡病例。伴后遗神经痛者,29.41%(5/17)持续3~12个月,29.41%(5/17)持续1~2年,17.65%(3/17)持续2~3年,23.53%(4/17)持续3年以上。结论以带状疱疹为早期表现的HIV感染者以中老年男性居多,多数有高危性行为史。患者病情重,皮损广泛,神经损伤恢复缓慢,复发率高,应注意加强HIV的早期筛查和积极治疗。
Objective To analyze the clinical features, treatment and prognosis of HIV-infected patients who show shingles as an early manifestation and to improve their understanding of the disease. Methods The clinical data of 39 HIV-infected patients who were diagnosed with herpes zoster at an early stage were analyzed retrospectively from July 2013 to January 2017. Results The average age was (51.54 ± 15) years old, 20 years old> 50 years old, 18 cases 20 ~ 50 years old, 1 case 15 years old, 71.79% (28) 39.38% (37/39) patients with lesions distribution ≥2 branches of the innervation of the nerve can be associated with bullae, blood blisters, pustules and visceral damage, neuralgia is more obvious; 15.38% ( 6 of 39 patients had CD4 ~ + T lymphocyte count less than 500 / μL; 56.41% (22/39) recovered, 43.59% (17/39) had neuralgia, 7.69% (3/39) Deaths. 29.41% (5/17) for 3 ~ 12 months, 29.41% (5/17) for 1-2 years, 17.65% (3/17) for 2-3 years, 23.53% 4/17) Lasts 3 years or more. Conclusion The majority of HIV-infected persons with herpes zoster as early-stage manifestation were middle-aged and elderly men, most of whom had high-risk sexual behaviors. Patients with severe illness, extensive skin lesions, nerve injury recovery is slow, high recurrence rate, should pay attention to strengthening early screening and aggressive treatment of HIV.