云南省HIV/AIDS合并耐多药结核病病人的筛查结果——附6例临床分析  

Screening results of multi drug resistant tuberculosis patients with HIV/AIDS in Yunnan province and clinical analysis of 6 cases

作　　者：张双梅 刘恒丽 杨欣平 陶鹏飞 王曦 李侠 ZHANG Shuangmei;LIU Hengli;YANG Xinping;TAO Pengfei;WANG Xi;LI Xia(Depart ment of Infectious Diseases, Yunnan Provincial Hospital of Infectious Disease /Yunnan AIDS Care Center, Kunming 650301 , China)

机构地区：[1]云南省传染病专科医院云南省艾滋病关爱中心

出　　处：《中国艾滋病性病》2018年第5期458-460,469,共4页Chinese Journal of Aids & STD

基　　金：国家科技重大专项(2018ZX10105006-003)~~

摘　　要：目的通过对新住院艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）的结核病（TB）筛查及确诊,对HIV/AIDS合并耐多药结核病例的临床分析,提高对该病的认识。方法回顾性分析云南省传染病专科医院感染一科2014年11月至2016年9月新入院HIV/AIDS病人结核病筛查及耐药结核病确诊病例临床资料及特征。结果所有701例HIV/AIDS病人中最终诊断结核病153人,包括确诊HIV/AIDS合并耐多药结核病人6例。确诊TB/HIV双重感染病人中,Xpert MTB/RIF阳性率为25.56%（23/90）,TB/HIV诊断效力最优。住院HIV/AIDS病人中,结核病患病率21.83%（153/701）,TB/HIV病人中,6例（3.92%）耐多药结核病患者均为男性,CD4＋T淋巴细胞计数9~113个/μL;常见临床症状及实验室异常为消瘦、超过两周的发热、血沉增快。2例病人接受规范耐多药结核病治疗方案,临床显效。结论应加强应用以Xpert RIF/MTB为核心的新的结核病诊断技术,并进一步规范HIV/AIDS病人合并耐多药结核病的筛查、确诊和治疗。Objective To improve the understanding of the diagnosis and treatment of HIV/AIDS combined with multi-drug resistant tuberculosis in newly hospitalized HIV/AIDS patients.Methods Retrospective analysis was made based on the clinical data and characteristics of tuberculosis screening and confirmed cases of drug-resistant TB in HIV/AIDS patients in Yunnan infectious disease hospital from Nov.2014 to Sept.2016.Results Out of all the HIV/AIDS 701 cases,153 cases were diagnosed as tuberculosis with the prevalence rate of TB/HIV 21.83%（153/701）.6 cases were diagnosed with multi drug resistant tuberculosis with the prevalence rate of 3.92%（6/153）.The positive rate of Xpert MTB/RIF was 22.7% with 6 male patients and CD4＋T lymphocyte counts of 9-113/μL.Common clinical symptoms and laboratory abnormalities included night sweat,fever for more than two weeks,and rapid ESR.Only 2 patients received standard multi drug resistant TB treatment,and clinically proven effective.Conclusion We should pay more attention to the screening,diagnosis and standard treatment of MDR-TB in HIV/AIDS patients.

关 键 词：艾滋病 耐多药结核病 回顾性研究 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]