CD4^+T细胞极低艾滋病患者合并肺结核21例临床分析  

Analysis of clinical features of 21 AIDS patients with very low CD4^+T cell count and coinfected with pulmonary tuberculosis

作　　者：陈礼运 黄芬 裘星凤 CHEN Li⁃yun;HUANG Fen;QIU Xing⁃feng(The Third People′s Hospital of Wuhu,Wuhu,Anhui 241000,China)

机构地区：[1]芜湖市第三人民医院感染科,安徽芜湖241000

出　　处：《热带医学杂志》2020年第3期387-390,共4页Journal of Tropical Medicine

摘　　要：目的分析CD4^+T细胞计数极低艾滋病合并肺结核患者的临床特点,为临床诊治提供依据。方法选择CD4^+T细胞计数低于50个/μL艾滋病合并肺结核患者21例给予规律抗结核治疗,适时给予抗逆转录病毒治疗(ART)。收集相关的临床和实验室数据,包括临床症状、影像学、免疫学和病原学检查结果等。结果患者主要临床表现有持续发热、消瘦、淋巴结肿大及肺外结核和肺部多重感染,影像学表现广泛浸润9例、粟粒样浸润6例、纵膈淋巴结肿大11例。结核菌素试验(TST)阳性率14.3%,结核病原学检查阳性8例。及时抗结核、抗病毒及防治其他机会性感染,19例病情得到有效控制,2例救治无效死亡。结论CD4^+T细胞计数极低的艾滋病合并肺结核患者临床表现复杂多样,及时诊断及合理治疗能取得良好疗效。艾滋病合并肺结核患者的临床特点及治疗与CD4^+T细胞水平有相关性。Objective To analyze clinical features of AIDS patients with very low CD4^+T cell count and coinfected with pulmonary tuberculosis,and provide evidence for clinical diagnosis and treatment.Methods 21 AIDS patients with very low CD4^+T cell(≤50/μL)count and coinfected with pulmonary tuberculosis were given regular anti-tuberculosis treatment and antiretroviral therapy(ART)at the appropriate time.Relevant clinical and laboratory data were collected,including clinical symptoms,imaging,immunology,pathogenic diagnosis results,etc.Results The main clinical manifestations of patients were persistent fever,weight loss,lymphadenopathy,extrapulmonary tuberculosis and multiple lung infections.Imageology examination showed 9 cases of extensive infiltration,6 cases of miliary infiltration,and 11 cases of mediastinal lymphadenopathy.Tuberculin test(TST)showed the positive rate was 14.3%.Etiology examination showed 8 patients were positive with tuberculosis.After timely anti-tuberculosis,anti-virus and prevention of other opportunistic infections,19 cases were effectively controlled,and 2 cases died.Conclusion Clinical features of AIDS patients with very low CD4^+T cell count and coinfected with pulmonary tuberculosis were complex and diverse.Patients achieve good therapeutic effect after timely diagnosis and reasonable treatment.The clinical features and treatment of patients with AIDS and coinfected with Pulmonary Tuberculosis were related to CD4^+T cell levels.

关 键 词：艾滋病 肺结核 CD4^+淋巴细胞 

分 类 号：R512.91[医药卫生—内科学] R521[医药卫生—临床医学]