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HIV感染者腹痛的评估

Author
C Mel Wilcox, MD
Section Editor
John G Bartlett, MD
Deputy Editor
Jennifer Mitty, MD, MPH
Translators
李在村, 主任医师，副教授

引言

人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者腹痛的鉴别诊断可能包括严重免疫缺陷时的机会性感染[如，巨细胞病毒(cytomegalovirus, CMV)、鸟分枝杆菌复合体(mycobacterium avium complex, MAC)]，也可能包括普通人群中较常见的一些其他病因(如，阑尾炎、憩室炎)。抗逆转录病毒治疗(antiretroviral therapy, ART)的广泛应用带来了很多药物副作用，包括胰腺炎和乳酸酸中毒综合征，这两者均可引起腹痛[1,2]。

本文将概述对HIV感染者腹痛的诊断。HIV感染者的其他胃肠道和肝胆并发症将单独讨论。 (参见“Evaluation of the HIV-infected patient with odynophagia and dysphagia”和“HIV感染者腹泻的评估”和“Evaluation of the HIV-infected patient with anorectal symptoms”和“HIV感染者的肝胆疾病评估”)

发生率

胃肠道不适(包括腹痛)的发生率还不明确。在高效ART用于临床之前，严重腹痛见于约15%的HIV感染者，并且与生存率下降相关[3]。

基本原则

在评估艾滋病患者的胃肠道不适时，几个基本原则很有用：

●单凭临床症状和体征很少能够明确诊断。

            

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Literature review current through: 2017-06 . | This topic last updated: 2015-08-18.
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