单纯肺结核病与HIV/AIDS合并肺结核的临床特征观察  

Clinical features observation on simple tuberculosis and HIV/IDS complicated with tuberculosis

作　　者：张孟璋[1] 李庶甘[1] 李茵[1] 蒋荣猛[2] 

机构地区：[1]厦门出入境检验检疫局,福建厦门361012 [2]北京地坛医院,北京100015

出　　处：《中国现代医生》2017年第26期86-88,共3页China Modern Doctor

摘　　要：目的探讨HIV/AIDS合并肺结核(TB)患者的临床特征。方法选择2010年1月~2016年12月于某传染病院接受治疗的HIV/AIDS合并TB患者320例为观察组,并选择同期治疗的单纯TB患者320例为对照组,对比两组临床特征,影像学检查结果及PPD结核菌试验、痰涂片等结果。结果观察组在发热、胸痛、消瘦的临床症状发生率显著高于对照组,且肺外结核发生率为71.56%显著高于对照组(P<0.05);观察组粟粒样病变为54.38%显著高于对照组,伴空洞形成为14.06%显著低于对照组(P<0.05);观察组浸润改变为88.75%,伴胸腔积液为25.94%与对照组对比无统计学差异(P>0.05);观察组双肺病变为86.88%显著高于对照组(P<0.05);观察组血清结核抗体检测(+)所占比例为39.06%,PPD结核菌试验(+)占24.06%、痰结核分枝杆菌培养(+)占0及痰涂片抗酸染色(+)占1.87%均显著低于对照组(P<0.05)。结论 HIV/AIDS合并TB患者临床特征无典型性,经免疫学与痰结核菌检测阳性率较低,临床诊疗时需结合疾病特征选择正确检测方案,明确诊治,以提高预后效果。Objective To explore the clinical characteristics of HIV/AIDS patients with tuberculosis（TB）. Methods A total of 320 HIV/AIDS patients with TB treated in certain infectious hospital from January 2010 to December 2016 were selected as the observation group. 320 simple TB patients treated in the same period were selected as the control group.The clinical characteristics,imaging results and the results of PPD tuberculosis test and sputum smear between the two groups were compared. Results The incidence of clinical symptoms including fever, chest pain and weight loss in the observation group was significantly higher than those in the control group. And the incidence of extrapulmonary tuberculosis in the observation group was 71.56%, which was significantly higher than that of the control group（P〈0.05）.The incidence of miliary lesions in the observation group was 54.38%, which was higher than that in the control group.And the incidence of miliary lesions combined with cavity formationin the observation group was 14.06%, which was significantly lower than that of the control group（P〉0.05）. The infiltration change was 88.75% in the observation group and 25.94% of combined pleural effusion, and there was no significant difference between the observation group and the control group（P〈0.05）. The incidence of double lung lesions in the observation group was 86.88%, which was significantly higher than that of the control group（P〈0.05）. The proportion of serum tuberculosis antibody（＋）（39.06%）,PPD tuberculosis test（＋）（24.06%）, mycobacterium tuberculosis culture（＋）（0） and sputum smear acid pickling（1.87%） in the observation group was significantly lower than those in the control group（P〈0.05）. Conclusion HIV/AIDS patients with TB have notypicalclinical characteristics, and the positive rate is low by immunology and sputum tuberculosis detection. In clinical diagnosis and treatment, the correct detection program is to be selected combine with the characteristics

关 键 词：单纯肺结核病 HIV/AIDS合并肺结核 临床特征 影像学特征 

分 类 号：R521[医药卫生—内科学]