广州地区Mtb/HIV双重感染筛查情况及临床疗效  

Screening and treatment for Mtb/HIV co-infection in Guangzhou

作　　者：杜雨华[1] 江坤洪[1] 陈其琛[1] 陶涛[1] 刘江 樊晖[1] DU Yu-hua;JIANG Kun-hong;CHEN Qi-cheng;TAO Tao;LIU Jiang;FAN Hui(Guangzhou Chest Hospital, Guangzhou Institute for Tuberculosis Control, Guangzhou, Guangdong 510095, China)

机构地区：[1]广州市胸科医院广州市结核病防治所,广东广州510095

出　　处：《热带医学杂志》2017年第12期1680-1683,共4页Journal of Tropical Medicine

摘　　要：目的探讨广州市结核病控制项目结核病/艾滋病(Mtb/HIV)双重感染筛查转介防治效果。方法收集分析广州市6个区(荔湾区、越秀区、海珠区、天河区、白云区、番禺区)2013-2014年登记的13 697例结核病患者和可随访到的9 093例人类免疫缺陷病毒(HIV)感染或获得性免疫缺陷综合症(AIDS)患者双向筛查情况,以及筛查出的肺结核与艾滋病双重感染患者治疗转归情况。结果 2013-2014年登记的结核病患者接受HIV抗体检测率为18.77%(2 571/13 926),HIV阳性检出率为0.19%(5/2 571)。可随访到的艾滋病患者经肺结核筛查,结核病患者检出率为1.87%(170/9 093)。艾滋病患者和结核病患者在Mtb/HIV双筛检出率上差异有统计学意义(χ~2=38.055,P<0.01)。双筛出的结核病与HIV双重感染患者抗痨治疗初治涂阳肺结核治愈率为69.23%,复治涂阳肺结核治愈率为42.86%,总体治疗成功率为72.05%,总体病死率为8.70%。结论 Mtb与HIV感染双向筛查是发现Mtb与HIV双重感染患者的主要途径,应加强结防机构与艾防机构合作机制,提高Mtb/HIV双重感染患者治疗成功率。Objective To investigate the screening and treatment for mycobacterium tuberculosis （Mtb）/human immunodeficiency virus （HIV） co-infection in the Guangzhou. Methods 13 697 cases of tuberculosis and 9 093 cases of HIV-infected or AIDS were collected and analyzed by two-way screening in six administrative regions of Guangzhou between 2013 and 2014. Prognosis of the patients treated for Mtb/HIV co-infection was also followed. Results Among patients with pulmonary tuberculosis registered from 2013 to 2014, the HIV antibody test rate was 18.77% （2571/13 926） , and 0.19% （5/2 571 ） was positive. The detection rate of reachable patients with HIV/AIDS screened for tuberculosis was 1.87% （ 170/9 093 ）. Of those, past-registered patients with HIV/AIDS were statistically different from newly-registered ones on the tuberculosis positive rate （χ2=9.333, P〈0.01 ） ; the two-way detection rate of Mtb/HIV co-infection was statistically varied between HIV/AIDS patients and tuberculosis patients （χ2=38.055, P〈0.01 ）. The cure rate for initial and retreated smear-positive pulmonary tuberculosis of the Mtb/HIV co-infected patients were 69.23% and 42.86%, respectively ; the total treatment success rate and total mortality rate were 72.05% and 8.70%, respectively. Conclusions Two-way screening of Mtb/HIV infection is the main way to discover the co-infection of Mtb/HIV. The anti tuberculosis organization and the anti epidemic organization should strengthen their cooperation to improve the success rate of treatment for the Mtb/HIV co- infected patients.

关 键 词：结核病 HIV 双重感染 

分 类 号：R52[医药卫生—内科学] R512.91[医药卫生—临床医学]