目的探讨分析糖皮质激素在艾滋病(AIDS)免疫重建炎性综合征(IRIS)中的应用价值。方法回顾性分析AIDS高效抗逆转录病毒治疗(HAART)过程中发生IRIS而使用糖皮质激素治疗的19例患者的临床资料。结果IRIS并发肺结核10例、结核性胸膜炎4例、颈淋巴结结核2例、结核性脑膜炎1例、隐球菌脑膜炎2例。表现为持续发热19例(100%),头痛呕吐3例(15.8%)。使用激素治疗前均给予非甾体类抗炎药物对症处理无效,经糖皮质激素治疗后好转。结论糖皮质激素可改善IRIS并发结核病、隐球菌脑膜炎的临床症状,提高患者治疗的依从性。
ObjectiveTo observe the applicative values with AID SIRIS by glucocorticoid. MethodsRetrospective analysis of the clinical data of 19 AIDS patients who were suffer IRIS during the process of HAART treatment and receiving glucocorticoids therapy.ResultsIn those who had IRIS,10 patients were complicated by pulmonary tuberculosis,4 by tuberculous pleuritis,2 by tuberculosis of neck lymph nodes,1 by tuberculous meningitis,2 by cryptococcal meningitis.19 patients(100%) were shown with continuous fever,headache and vomiting in 3 cases(15.8%).Before glucocorticoid treatment,all patients received symptomatic treatment by nonsteroidal anti-inflammatory drug and show no avail,but improved after treated with glucocorticoid.ConclusionGlucocorticoid can improve the clinlcal symptom of IRIS that complicated with tuberculosis,cryptococcal meningitis,and improve patients, compliance.