艾滋病合并结核病的临床分析  

Clinic analysis on cases of acquired immunodeficiency syndrome with tuberculosis

作　　者：王卫华[1] 赵恒敏 张和武[1] 

机构地区：[1]华中科技大学同济医院,武汉,430030 [2]武汉市商业职工医院,武汉,430021

出　　处：《中国防痨杂志》2003年第z1期67-68,共2页Chinese Journal of Antituberculosis

摘　　要：目的探讨艾滋病合并结核病的临床特点.方法对1998年至2002年11例艾滋病合并结核病进行临床分析.结果 (1)艾滋病感染途径:输血感染者8例,其他途径各1例.(2)合并肺结核病6例,其中继发性肺结核3例,原发性肺结核1例,血行播散性肺结核2例;合并肺外结核5例,其中结核性心包积液、结核性脑膜炎各2例,胸腔积液1例;合并多重感染者5例.(3)11例1:2000PPD试验均为阴性.(4)治疗:7例抗病毒与抗结核联合治疗,临床表现明显改善;3例仅抗结核治疗者中1例有效、2例死亡;1例未经任何治疗,6月死亡.结论艾滋病合并结核病临床表现多样,血行播散性肺结核多,肺外结核多,多重感染多见,抗病毒与抗结核联合治疗有效.Objective To determine the clinical characters of acquired immunodeficiency syndrome (AIDS) complicated with tuberculosis cases.Methods 11 AIDS complicated with tuberculosis cases from 1998 to 2002 were analyzed.Results (1)Transmission route:8 cases (73%) were infected by transfusion.(2)Clinical type:6 cases (54.6%) were diagnosed as AIDS complicated with pulmonary tuberculosis.Among those 6 cases,3 cases were infiltrating pulmonary tuberculosis,1 case was primary pulmonary tuberculosis,2 cases were disseminated tuberculosis.5 cases (45.4%) were diagnosed as AIDS complicated with extra-pulmonary tuberculosis.Among of those 5 cases,2 cases were tubercular pericardial effusion,2 cases were tuberculous meningitis and 1 case was tubercular pleural effusion case.5 cases (45.4%) were with multi-infections.(3)PPD test:The results of 1∶2000 PPD tests were negative of 11 cases.(4)Treatment:Clinical manifestations were found improved obviously in 7 cases that received treatment with anti-tuberculosis and anti-retrovirus treatments.Among 3 patients that received anti-tuberculosis treatment only,Clinical manifestations were found improved obviously in 1 case,2 cases died.1 case without any treatment died after 6 months.Conclusion The most cases were infected from transfusion.Among AIDS complicated with tuberculosis,circulating disseminated tuberculosis and extra-pulmonary tuberculosis were common and usually combined with other various opportunistic infection,clinical manifestations were complex.There was no meaning of PPD test for diagnose AIDS with tuberculosis.The combined anti-tuberculosis and anti-retrovirus treatments were efficient to cases of AIDS with tuberculosis.

关 键 词：艾滋病 结核 

分 类 号：R512.91[医药卫生—内科学]