126例HIV/结核分枝杆菌合并感染临床观察  

Clinical analysis of 126 patients with HIV and Mycobacterium tuberculosis coinfection

作　　者：伍秋云[1] 卢祥婵[1] 黄爱春[1] 谢志满[1] 何华伟[1] 朱庆东[1] 苏绮思[1] 李清蓉[1] 阮光靖[1] 欧汝志[1] 

机构地区：[1]广西壮族自治区南宁市第四人民医院暨广西艾滋病临床治疗中心,530023

出　　处：《传染病信息》2015年第2期108-111,共4页Infectious Disease Information

基　　金：国家"十二五"科技重大专项(2012ZX10001-003);广西科学研究与技术开发计划项目(1298003-1-3)

摘　　要：目的观察治疗HIV/结核分枝杆菌(Mycobacterium tuberculosis,MTB)合并感染的临床疗效。方法分析126例HIV/MTB合并感染者的临床疗效,统计高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)后1年内免疫重建炎症反应综合征(immune reconstitution inflammatory syndrome,IRIS)发病率及CD4+T淋巴细胞上升水平。结果 126例均完成了抗结核治疗,HAART 1年内无死亡及复发结核病例。HAART后CD4+T淋巴细胞计数逐渐升高,以12周时上升幅度最大。治疗过程中37例(29.37%)出现IRIS。CD4+T淋巴细胞计数<200个/mm3组IRIS发病率高于≥200个/mm3组(χ2=6.206,P=0.013),且在HAART后12周及48周CD4+T淋巴细胞上升幅度低于≥200个/mm3组(P<0.05)。结论 HIV/MTB合并感染者在CD4+T淋巴细胞≥200个/mm3时接受HAART,IRIS发病率低,免疫重建良好。Objective To investigate the therapeutic efficacy on HIV and Mycobacterium tuberculosis （MTB） coinfection. Methods The incidence of immune reeonstitution inflammatory syndrome （IRIS） and the increased level of CD4^＋ T lymphocyte count were observed within one year after giving highly active antiretroviral therapy （HAART） in 126 patients with HIV/MTB coinfection, so as to analyze the clinical effects. Results All the 126 patients completed TB treatment and within one year after receiving HAART, there were no death and reoccurrence of TB. CD4^＋ T lymphocyte count increased gradually after HAART and increased the most greatly at week 12. During the treatment, IRIS was found in 37 patients （29.37%）. The incidence of IRIS in patients with CD4^＋ T lymphocyte count less than 200 cells/mm^3 was higher than that in patients with CD4^＋ T lymphocyte count equal to or more than 200 cells/mm^3 （χ^2=6.206, P=0.013）. The increases in CD4^＋T lymphocyte count at week 12 and 48 in patients with CD4^＋ T lymphocyte count less than 200 cells/mm^3 were less than those in patients with CD4^＋ T lymphocyte count equal to or more than 200 cells/mm^3 （P〈0.05）. Conclusions The patients with HIV/MTB coinfection who initiate HAART when their CD4^＋ T lymphocyte counts are equal to or more than 200 cells/mm^3 have a low incidence of IRIS, showing a good immune reeonstitution.

关 键 词：HIV 重叠感染 结核 

分 类 号：R373.51[医药卫生—病原生物学]