HIV/AIDS感染合并肺结核与HIV/AIDS实验室检测指标对比分析  

Comparative analysis of the clinical symptoms and laboratory examination indexes between patients with HIV/AIDS infection complicated with tuberculosis and those with HIV/AIDS alone

作　　者：赵川[1] 王容[1] 李毅[1] 杨凤[1] 王文平[1] 周红[1] 谭敏[1] 舒丽[1] ZHAO Chuan;WANG Rong;LI Yi;YANG Feng;WANG Wenping;ZHOU Hong;TAN Min;SHU Li(Department of Infectious Diseases,Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]四川省遂宁市中心医院感染科,四川遂宁629000

出　　处：《公共卫生与预防医学》2020年第6期83-87,共5页Journal of Public Health and Preventive Medicine

基　　金：四川省卫生计生委科研项目(150244)。

摘　　要：目的探讨人体免疫缺损病毒(HIV)艾滋病(AIDS)感染合并肺结核(TB)与HIV/AIDS患者临床症状、实验室检查指标的差异,为HIV/AIDS感染合并TB的早期识别和诊断提供参考。方法以2015年1月—2019年4月遂宁市中心医院收治的206例HIV/AIDS感染合并TB患者作为研究组,选取86例单纯HIV/AIDS患者作为疾病对照组,对病例患者的临床诊治资料、随访资料进行回顾性分析,比较两组临床症状、实验室检查指标以及临床治疗转归。结果研究组发热、消瘦、电解质紊乱、低蛋白血症、咳嗽、胸痛发生率明显高于疾病对照组,差异有统计学意义(P<0.05),其它症状两组间比较差异无统计学意义(P>0.05);研究组痰涂片抗酸染色阳性、痰结核分枝杆菌培养阳性、PPD试验阳性明显高于疾病对照组,CD3^+和CD4^+细胞计数、CD4^+/CD8^+明显低于疾病对照组(P<0.05),两组CD8^+细胞计数比较差异无统计学意义(P>0.05),ROC曲线提示CD3、CD4^+、CD4^+/CD8^+以及三者联合指标评估HIV/AIDS感染合并TB的曲线下面积分别为0.799、0.841、0.913和0.935;研究组住院天数明显长于疾病对照组,出院(好转)占比较疾病对照组明显低,出院(未好转)占比明显高于疾病对照组(P<0.05)。结论与单纯HIV/AIDS相比,尽管HIV/AIDS感染合并TB患者的临床症状较为类似,但后者以发热、消瘦、电解质紊乱等症状为主,且实验室免疫功能指标的联合检测在提高HIV/AIDS感染合并TB患者的早期诊断的灵敏度和准确度方面有积极意义。Objective To explore the differences in clinical symptoms and laboratory examination indexes between patients with HIV/AIDS infection complicated with tuberculosis(TB)and those with HIV/AIDS alone,so as to provide a reference for early identification and diagnosis of HIV/AIDS infection with TB.Methods A total of 206 patients with HIV/AIDS infection and TB who were admitted to Suining Central Hospital from January 2015 to April 2019 were selected as the study group.86 patients with pure HIV/AIDS were selected as the disease control group.Data of clinical diagnosis and treatment as well as follow-up of the patients were retrospectively analyzed.The clinical symptoms,laboratory examination indexes and clinical treatment outcomes were compared between the two groups.Results The incidence rates of fever,emaciation,electrolyte imbalance,hypoproteinemia,cough and chest pain in the study group were significantly higher than those in the disease control group(P<0.05).However,there was no significant difference in other symptoms between the two groups(P>0.05).The positive rates of sputum smear acid fast stain,sputum mycobacterium tuberculosis culture and PPD test in the study group were significantly higher than those in the disease control group,while the CD3^+count,CD4^+count and CD4^+/CD8^+were obviously lower than the disease control group(P<0.05).There was no significant difference in CD8^+between the two groups(P>0.05).The ROC curve suggested that the areas under the curve of CD3,CD4^+,CD4^+/CD8^+and the three combined indicators to evaluate HIV/AIDS infection combined with TB were 0.799,0.841,0.913,and 0.935,respectively.The hospitalization time in the study group was significantly longer than that in the disease control group.The proportion of discharged patients(improved)in the study group was significantly lower than that in the disease control group,while the proportion of discharged patients(not improved)was significantly higher than that in the disease control group(P<0.05).Conclusion Although the clinical sym

关 键 词：HIV AIDS 肺结核 症状 

分 类 号：R183[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]