河南地区HIV/AIDS合并结核病的临床分析  

Clinical analysis of HIV/AIDS combined with tuberculosis in Henan Province

作　　者：孙燕[1] 杨萱[1] 于永敏[1] 刘春礼[1] 何云[1] 赵清霞[1] 

机构地区：[1]郑州市第六人民医院感染科,450015

出　　处：《传染病信息》2012年第6期364-366,共3页Infectious Disease Information

基　　金：国家"十一五"科技重大专项(2008ZX1001-008)

摘　　要：目的探讨HIV/AIDS合并结核病的临床特点,以提高对其的认识。方法对我院2006年6月—2010年8月收治的208例HIV/AIDS合并结核病患者的临床资料进行回顾性分析。结果 208例中男137例,女71例,年龄(35.7±11.3)岁。临床分型为继发性肺结核(102例)、肺外结核(47例)、结核性胸膜炎(36例)、血型播散型肺结核(22例)和原发型肺结核(1例)。对181例的CD4+T淋巴细胞计数进行检测,其中≤50个/mm3有107例,55例为51～200个/mm3,15例为201～350个/mm3,4例为>350个/mm3。198例接受抗结核治疗,其中157例耐受抗结核治疗的同时接受高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)。结果存活121例,失访53例,死亡34例。结论 HIV/AIDS合并结核病感染临床表现复杂多样,诊断治疗困难,预后差。免疫功能低下是HIV/AIDS合并结核病的主要原因,早期诊断并联合HAART可改善预后。Objective To investigate the clinical features of HIV/AIDS combined with tuberculosis （TB）, so as to improve the understanding of the disease. Method The clinical data of 208 HIV/AIDS patients with TB treated in our hospital from Jun. 2006 to Aug. 2010 were retrospectively analyzed. Results Of 208 HIV/AIDS patients with TB, 137 were males and 71 were females with the average age of 35.7±11.3 years old. Secondary pulmonary TB was found in 102 patients, extrapulmonary TB in 47 patients, TB pleurisy in 36 patients, blood type disseminated TB in 22 patients and original TB in 1 patient. CD4＋ T lymphocyte counts were de- tected in 181 patients, with CD4＋〈50/mm3 in 107 patients, 51-200/mm3 in 55 patients, 201-350/mm3 in 15 patients, and 〉350/mm3 in 4 patients. Totally 198 patients received anti-TB treatment, in addition, 157 patients received highly active antiretroviral therapy （HAART） simultaneously. It was shown that 121 patients survived, 53 were lost during the follow-up and 34 died. Conclusions HIV/ AIDS combined with TB is characterized by complex and diverse clinical manifestations, difficult diagnosis and treatment and poor prognosis. Immune dysfunction is the major cause that leads to the combination of HIV/AIDS and TB, and making early diagnosis and taking HAART may improve the prognosis.

关 键 词：HIV 获得性免疫缺陷综合征 结核 肺 同时感染 

分 类 号：R373.51[医药卫生—病原生物学] R521[医药卫生—基础医学]