全球精选文摘 - 人类免疫缺陷病毒-1感染对急性输卵管炎治疗预后的影响

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人类免疫缺陷病毒-1感染对急性输卵管炎治疗预后的影响

Effect of Human Immunodeficiency Virus-1 Infection on Treatment Outcome of Acute Salpingitis

Mugo NR, Kiehlbauch JA, Nguti R 2009/5/27 10:50:40

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Obstet Gynecol, 2006,

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Abstract

Objective:

To examine the effect of human immunodeficiency virus (HIV)—1 infection on treatment outcome of laparoscopically verified acute salpingitis.

Methods:

Women aged 18–40 years with laparoscopically verified acute salpingitis received antibiotic therapy that included cefotetan 2 g intravenously and doxycycline 100 mg orally every 12 hours and laparoscopically guided drainage of tuboovarian abscesses of 4 cm or more. Clinical investigators blinded to HIV-1 serostatus used predetermined clinical criteria, including calculation of a clinical severity score and a standard treatment protocol to assess response to therapy.

Results:

Of the 140 women with laparoscopically confirmed acute salpingitis, 61 (44%) women had mild, 38 (27%) had moderate, and 41 (29%) had severe disease (ie, pyosalpinx, tuboovarian abscesses, or both). Fifty-three (38%) were HIV-1–infected. Severe disease was more common in HIV-1–infected in comparison with HIV-1–uninfected women (20 [38%] compared with 21 [24%], P = .02). Defined as time of hospital discharge or 75% or more reduction in baseline clinical severity score, HIV-1–infected women with severe (6 days [4–16] compared with 5 days [3–9], P = .09) but not those with either mild (4 days [2–6] compared with 4 days [2–6]P = .4) or moderate salpingitis (4 days [3–7] compared with 4 days [3–6]P = .32) tended to take longer to meet criteria for clinical improvement. The need for intravenous clindamycin or additional surgery was not different in HIV-1–infected and uninfected cases (15 [28%] compared with 18 [21%], P = .3).

Conclusion:

Although HIV-1 infection may prolong hospitalization in women with severe salpingitis, all women hospitalized with acute salpingitis responded promptly to antibiotic therapy and surgical drainage regardless of HIV-1 infection status.

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疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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