摘要
目的研究艾滋病(AIDS)病人消化道黏膜病变的内镜及病理特征。方法对北京地坛医院1995-2009年期间收治的AIDS病人中,经临床、内镜、病理确诊并发食道、肠道黏膜病变的62例病例资料做回顾性分析。结果 62例中,31例食道黏膜病变病人胃镜像显示不同程度的黏膜弥漫性充血、水肿,点片状白斑、白色伪膜或条索样、絮状真菌团块(6例并发食管黏膜溃疡)。其中16例病人病理检测到真菌菌丝或孢子而被确诊真菌性食管炎。33例肠道黏膜病变病人(2例同时合并食道黏膜病变)结肠镜像显示,除2例黏膜未见明显异常外,余31例均有结肠黏膜病变。慢性结肠炎14例,慢性结肠炎伴结肠溃疡15例,阿米巴性溃疡和回盲部恶性淋巴瘤(非霍奇金淋巴瘤)各1例。病理学特点:急慢性食管、结肠炎,主要表现为黏膜组织疏松水肿,伴炎性细胞浸润,而溃疡除炎性病理改变外,伴有黏膜局灶、片状坏死,中性粒细胞浸润,呈非特异性炎症改变。结论 AIDS病人合并消化道黏膜病变肠道溃疡的发生率要高于食道。肠道黏膜病变以慢性结肠炎和结肠溃疡为主,同时可并发恶性肿瘤。
Objective To study endoscopic and pathological gastrointestinal mucosal lesions in AIDS patients.Methods Retrospective study was conducted among AIDS patients admitted to our hospital from 1995 to 2009 who were confirmed as concurrent esophagus and intestinal mucosa lesions by clinical,endoscopic and pathological diagnosis.Results Thirty one cases with esophageal mucosa lesions displayed varying degrees of esophageal mucosal hyperemia,edema,diffuse white spot or flake pseudo membrane under endoscopy,of whom 6 were complicated with esophagus ulcer;16 cases with fungal hyphae or spores were detected by pathological examination;in 33 cases with intestinal mucosa lesions（2 with esophageal mucosal lesions）,the colon image showed no obvious mucosal abnormality except in 2 cases,and rest 31 cases had colon mucosal lesions;14（45.16%） cases had chronic colitis,15（48.39%） cases had chronic ulcer colitis,and amebic ulcers and ileocecal malignant lymphoma（non-Hodgkin＇s lymphoma） were seen in 1 case separately.Pathological study showed acute and chronic esophagitis,and colitis which was mainly manifested in loose edema of mucosal tissue associated with inflammatory cell infiltration,and the ulceration,in addition to inflammatory pathology,was complicated with associated focal mucosa,necrosis,neutrophil infiltration,and non-specific inflammatory changes.Conclusion The incidence of gastrointestinal mucosal lesions in AIDS patients are higher than that of esophageal leasons,and the intestinal mucosal lesions are mainly displayed as chronic colitis and colon ulcer,and will possibly be complicated with malignancy.
出处
《中国艾滋病性病》
CAS
2011年第3期320-323,共4页
Chinese Journal of Aids & STD
关键词
艾滋病
消化道黏膜病变
胃镜像
结肠镜像
病理学特征
AIDS
Gastrointestinal mucosa lesions
Gastroscopy image
Colonoscopy image
Pathologic characteristic
