摘要
目的研究HIV相关Kaposi肉瘤(Kaposi sarcoma,KS)的临床表现、诊断、治疗和预后。方法回顾性分析2004年-2014年收治的5例KS临床资料并复习相关文献。结果5例患者均为男性,汉族,年龄26~37岁,3例以KS为首诊疾病,另2例在抗病毒治疗(antiretroviral therapy,ART)后发生,均出现皮肤损害,并伴有多组织浸润。1例患者未接受化疗,6个月后因为消化道出血死亡。另4例患者均给予化疗,其中1例患者治疗后CD_4^+细胞升高至正常水平,复查提示所有病灶消失,长期存活;3例患者给予多柔比星脂质体规律化疗4个周期后皮肤、口腔和眼睑部位病灶明显缩小和减少,肺部和胃肠道病灶消失,而且CD_4^+细胞有所升高,但未升至正常水平。其中1例延长治疗病灶再次增多,调整治疗方案后病情有所控制,另2例未再继续化疗,监测病情平稳,仍在密切随访中。结论KS一般均有皮肤损害表现,而且可能伴有多脏器浸润。KS诊断难度不大,积极治疗均可使病灶缩小甚至消失,但需监测可能发生的并发症。如果经治疗后CD_4^+细胞升高,患者预后更佳,甚至完全治愈。
Objective To investigate the clinical manifestations, diagnosis, treatment and prognosis of HIV related Kaposi sarcoma （KS）. Methods From 2004 to 2014, the clinical data of 5 KS patients were retrospectively analyzed and re-view of the literature. Results These were 5 male patients, aged between 26-37 years old, 3 cases were first diagnosed as KS, another 2 cases were diagnosed after antiviral therapy （ antiretroviral therapy, ART） , all occurred with the skin damage, followed by multiple tissue infiltration. 1 patient didn’ t received chemotherapy, after 6 months, dead due to hemorrhage of di-gestive tract. The other 4 patients were given chemotherapy, in which 1 patients＇ CD4^＋ cells was increased to normal levels after the treatment, all lesions disappeared during follow-up examination, and experienced long-term survival. The other 3 patients were given chemotherapy with doxorubicin liposome of 4 cycles, the skin, oral and eyelid lesions were significantly decreased, lung and gastrointestinal lesions disappeared, and CD4^＋ cells was increased, but not increased to the normal level. In 1 case of prolonged treatment, lesions increased again, after adjusting treatment, these symptoms were under control, the other 2 cases did not continue chemotherapy, monitoring condition revealed steady, is still under closely follow up. Conclusion KS is gen-erally combined with skin damage, and may be accompanied by multiple organ infiltration. Diagnosis of KS is not difficult, ac-tive treatment can decrease the size of lesions, but monitoring the possible complications is needed. If CD4^＋ cells is increased after the treatment, then the prognosis would be better, or even completely cured.
出处
《疑难病杂志》
CAS
2015年第2期151-153,157,共4页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金(No.81201294)
北京市自然科学基金(No.7132077)
艾滋病研究北京市重点实验室(No.BZ0089)
北京市医院管理局临床医学发展专项经费资助(No.ZY201401)
