论文部分内容阅读
对2019年1月苏州大学附属儿童医院重症医学科收治的1例以缺血性脑卒中为主要表现的获得性免疫缺陷综合征患儿的临床资料进行回顾性分析。患儿，男，6岁4个月，既往有血小板减少性紫癜和反复呼吸道感染病史。主诉“右侧肢体乏力10余天”。头颅磁共振成像提示双侧额顶叶较广泛异常信号伴左侧丘脑、外囊软化灶形成。血常规示白细胞4.88×10n 9/L，淋巴细胞比例0.291，淋巴细胞计数1.42×10n 9/L，血红蛋白99 g/L，血小板23×10n 9/L。淋巴细胞亚群：CD3n ＋ 84.1%，CD3n ＋CD4n ＋ 0.2%，CD3n ＋CD8n ＋ 61.4%，CD4n ＋/CD8n ＋ 0，CD3n -CDn 19＋ 9.2%，CD3n -CDn 16＋56＋ 6.1%，CDn 19＋CDn 23＋5.8%。输血前检查：人类免疫缺陷病毒(HIV)(＋)，余阴性。患儿父母双方均为HIV感染患者。本病例提示神经系统受累症状在HIV感染中并不少见，且脑卒中是HIV感染患儿出现临床局灶性神经功能缺损的最常见原因。高危患儿出现其他神经受累表现或认知改变，须尽早完善头颅磁共振检查。n “,”Clinical data of a child with acquired immunodeficiency syndrome characterized by ischemic stroke who was admitted to the Pediatric Intensive Care Unit of Children′s Hospital Affiliated to Soochow University in January 2019 were retrospectively analyzed.The child is a 6 years and 4 months old boy with a history of thrombocytopenic purpura and recurrent respiratory infections.The main complaint was “ the right limb weakness for more than 10 days” . The head magnetic resonance imaging (MRI) revealed extensive abnormal signals in the bilateral frontal and parietal lobes and the formation of softening foci in the left thalamus and outer capsule.Blood routine showed white blood cell 4.88×10 n 9/L, lymphocyte ratio 0.291, lymphocyte count 1.42×10n 9/L, hemoglobin 99 g/L, and platelet 23×10n 9/L.Lymphocyte subsets included CD3n + 84.1%, CD3n + CD4n + 0.2%, CD3n + CD8n + 61.4%, CD4n + /CD8n + 0, CD3n -CDn 19+ 9.2%, CD3n -CDn 16+ 56+ 6.1%, and CDn 19+ CDn 23+ 5.8%.Pretransfusion tests suggested human immunodeficiency virus (HIV) (+ ), and that other results were negative.Both parents of the child were infected with HIV.This paper demonstrates that neurological involvement is not rare in HIV infection, and stroke is the most common cause of clinical focal neurological deficits in HIV-infected children.Screening with MRI is recommended for high-risk children with neurologic symptoms or neurocognitive dysfunction.n