陕西省TB与HIV/AIDS双向筛查及TB/HIV患者抗结核治疗转归队列分析  

Double screening test results and cohort analysis of antitubercular treatment outcomes of TB/HIV patients in Shaanxi

作　　者：许静 郑全庆 张天华 马煜 杜昕 XU Jing;ZHENG Quanqing;ZHANG Tianhua;MA Yu;DU Xin(School of Public Health, Department of Medicine, Xi＇an Jiaotong University, Xi＇an, Shaanxi 710061, China;Shaanxi Provincial Institute for Tuberculosis Control and Prevention, Xi＇an, Shaanxi 710048, China)

机构地区：[1]西安交通大学医学部公共卫生学院,陕西西安710061 [2]陕西省结核病防治研究所,陕西西安710048

出　　处：《中国热带医学》2018年第6期619-623,共5页China Tropical Medicine

摘　　要：目的了解陕西省TB/HIV(结核分枝杆菌/艾滋病病毒)双重感染防治工作。提高TB/HIV发现、治疗和管理力度,控制结核病和艾滋病的进一步传播,保护公众健康。方法收集整理和分析2010—2017年陕西省各地上报的《TB/HIV双重感染防治管理工作年度报表》。结果 2010—2017年,累计接受HIV抗体检测的结核病患者43 304例,检测率25.10%,HIV检测阳性数16例,阳性检出率0.04%;同期,HIV/AIDS患者中,新检出的HIV/AIDS中接受X线胸片或查痰9 666人,结核病检查率76.81%;诊断TB/HIV双重感染患者224人,结核病患者检出率2.32%;既往的HIV/AIDS中接受X线胸片或查痰24 277人次,结核病检查率80.43%;诊断TB/HIV双重感染患者105人,结核病患者检出率0.43%;结核中筛HIV/AIDS,新检出HIV/AIDS中筛结核,既往HIV/AIDS中筛结核,三组检出率两两进行对比,差别均有统计学意义(P<0.001);共进行抗结核治疗263例,抗结核治疗率76.23%;进行抗病毒治疗256例,抗病毒治疗率74.20%;抗结核治疗的TB/HIV患者中治愈35例(17.59%),完成疗程率141例(70.85%),结核死亡1例(0.50%),非结核死亡15例(7.54%),丢失2例(1.00%),其他5例(2.51%)。结论双向筛查是切实有效的早期发现TB/HIV的方法,有利于提高TB/HIV的早期发现,并能提高TB/HIV双重感染患者结核病的治疗成功率、降低结核病死亡率,有效的控制TB/HIV双重感染疫情。Objective To understand the tuberculosis （TB）/human immunodeficiency virus （HIV） co-infection control status in Shaanxi Province, improve the detection rate, success treatment rate and management of TB/ HIV dual infection patients, control the further spread of TB and HIV/AIDS, so as to protect public health. Methods The annual reports of TB/HIV co-infection were collected from various regions in Shaanxi Province from 2010 to 2017 for analysis. Results From 2010 to 2017, HIV antibodies were detected in 43 304 patients （25.10%）, and 16 patients of HIV infection were detected （0.04%）. At the same time, a total of 9 666 cases （76.81%） of new reported HIV/AIDS were conducted X-ray chest examinations or sputum smear detections, and 224 TB patients were found （2.32%）. A total of 24 277 cases/times （80.43%） of previously-recognized HIV/AIDS were conducted X-ray chest examinations or sputum smear detections, and 105 TB patients were found （0.43%）. There were significant differences among the three groups in terms of TB screening HIV, newly detected HIV screening TB and previous HIV screening TB （P〈0.001）. A total of 263 patients received anti-TB treatment （76.23%） and 256 （74.20%） received antiretroviral treatment, 35 （17.59%） patients were cured, and 141 （70.85%） cases completed the treatment. One （0.50%） TB patient died, 15 （7.54%） non-TB patients died, 2 （1.00%） cases were lost, and 5 （2.51%） cases had other reasons for non-statistics. Conclusions The TB/HIV double screening strategy is an effective way to early detection of TB/HIV. Two-way screening can improve the successful treatment rate of TB/HIV, reduce TB mortality, and effectively control TB/HIV infection.

关 键 词：结核病 艾滋病 双重感染 

分 类 号：R52[医药卫生—内科学]