获得性免疫缺陷病是近年来才被认识的疾病。1981年6月美国首先报告此病(Acquired immuno-deficiency syndrome)简称爱滋病(AIDS)。它是一种发生在60岁前,身体健康,主要见于男性同性恋者、吸毒者、海地人和赤道非洲的扎依尔人以及最近发现在接受输血的血友病患者,大多由性交或受污染的血液所传染。本病表现为helper T淋巴细胞即辅助性T细胞(OKT 4阳性细胞)的细胞免疫机能不全,伴有条件性微生物趁机感染和/或Kaposi肉瘤。本综合征的病因不详,最近研究,很可能是一种属于逆转录病毒(retrovirus)的病毒为传染源。作者等从眼科方面检查3例AIDS病人,均有非特异性眼底表现:2例有棉絮状白斑,一例有巨细胞病毒性视网膜坏死,后者的眼球在死后经病理解剖检查证实临床所见是由病毒引起的坏死性视网膜炎。一般症状:本病虽分几个阶段,但各阶段的经过方式不详。AIDS病所表现的病征有表浅多腺病和/或Kaposi肉瘤。全身症状包括难以解释的消瘦、不规则发热、腹泻、无力。一些结节为非特异性增殖反应。Kaposi肉瘤偶见于发病初期。皮肤呈紫红色散在性斑块或结节,在玻片压迫下不退色。附近皮肤、表浅淋巴结、消化道粘膜、心、肺、肝等处损害可能迅速扩展。皮肤活检发现内皮和成纤维细胞增殖。在此早期,免疫学检查正常。结核菌素或念珠菌素皮肤试验阳性,许多辅助性T细胞和抑制性T细胞(OKT4阳性细胞,OKT8阳性细胞)对丝状分裂原(mitogen)呈淋巴增殖反应。少数病例(少于10%)的病程由数月至2年间向严重的全身免疫缺陷发展。病程已久的AIDS病诊断较易,是一种多发性感染,与细胞内发展的下列微生物有关: (1)分枝杆菌属:结核杆菌或鸟结核分枝杆菌能感染所有脏器。(2)原虫类:主要是卡氏肺囊虫性肺病,脑弓形体病,肠道隐性孢子虫病, (3)病毒:巨细胞病毒能感染肺,大脑、视网膜;单疱病毒则侵犯皮肤及粘膜。(4)真菌:口腔或食道念珠菌病,新生囊球菌性脑膜炎,曲菌性肺病。在同一病人可相继或同时感染多种疾病。在一种感染未出现明显先兆病征前,已有病因不明的细胞免疫缺陷。在该期淋巴细胞常减少,尤其是T淋巴细胞(OKT 4阳性细胞)的绝对数下降,因此辅助性T细胞/抑制性T细胞的比率显著下降, Acquired immunodeficiency disease is a disease that has only been recognized in recent years. June 1981 the United States first reported the disease (Acquired immuno-deficiency syndrome) referred to as AIDS (AIDS). It is a Zayiar who was healthy before the age of 60 and was mainly found in gay men, drug addicts, Haitian and equatorial Africa, and hemophilia, which was recently discovered to be transfused, mostly by sexual intercourse or contamination Infected by the blood. The disease manifests itself as a cellular immune deficiency of helper T lymphocytes, OKT 4-positive cells, associated with the opportunistic infection of microorganisms and / or Kaposi’s sarcoma. The etiology of this syndrome is unknown, and recent research is likely to be a source of retroviral viruses. The authors examined 3 cases of AIDS patients ophthalmically, both non-specific fundus findings: two cases of lint-like white spots, a case of cytomegalovirus retinal necrosis, which after the death of the eye by pathological anatomy confirmed the clinical findings are Necrotizing retinitis caused by a virus. General symptoms: Although the disease is divided into several stages, but the way through the stages is unknown. Symptoms of AIDS include superficial adenosis and / or Kaposi’s sarcoma. Systemic symptoms include unexplained weight loss, irregular fever, diarrhea, and weakness. Some nodules are nonspecific proliferative responses. Kaposi sarcoma occasionally in the early stages of onset. Skin was purple scattered patches or nodules, under the oppression of the slide does not fade. Damage to nearby skin, superficial lymph nodes, gastrointestinal mucosa, heart, lungs and liver may rapidly expand. Skin biopsy revealed endothelial and fibroblast proliferation. In this early stage, immunological examination is normal. Tuberculin or Candida skin test was positive, and many helper T cells and suppressor T cells (OKT4 positive cells, OKT8 positive cells) showed lymphoproliferative response to mitogen. In a minority of cases (less than 10%) the course of disease progresses from severe to systemic immunodeficiency from months to 2 years. The long-awaited AIDS diagnosis is easier and is a multiple infection associated with the following intracellular microbial development: (1) Mycobacteria: Mycobacterium tuberculosis or Mycobacterium tuberculosis can infect all organs. (2) Protozoa: mainly Pneumocystis carinii pneumonitis, Toxoplasmosis, cryptosporidiosis of the intestine; (3) Viruses: cytomegalovirus can infect the lung, brain and retina; herpes simplex virus invades Skin and mucous membranes. (4) fungi: oral or esophageal candidiasis, meningococcal meningitis, asymptomatic lung disease. In the same patient may be infected with multiple diseases either at the same time. In an infection without obvious signs of disease before, there have been unknown etiology of cellular immune defects. During this period lymphocytes often decreased, especially the absolute number of T lymphocytes (OKT 4 positive cells) decreased, so the proportion of helper T cells / suppressor T cells decreased significantly,