艾滋病合并结核病的临床分型特点  

The clinical typing features of acquired immune deficiency syndrome and tuberculosis co-infection

作　　者：古丽米拉·达列力汗 齐曼古力·吾守尔[1] 宋玉霞 李弘 钟燕霞[3] GULIMILA Dalielihan;QIMANGULI Wushouer;SONG Yu-xia(Department of Respiratory Medicine,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院呼吸科,830011 [2]新疆医科大学第八附属医院艾滋病临床医学研究中心,830013 [3]新疆医科大学第八附属医院呼吸科,830013

出　　处：《中国实用医药》2022年第22期148-152,共5页China Practical Medicine

基　　金：新疆维吾尔自治区重大科技专项(项目编号:2017A03006-2)。

摘　　要：目的总结分析新疆医科大学第八附属医院2014~2017年艾滋病病毒(HIV)/艾滋病(AIDS)合并结核病的临床分型及其特征。方法回顾性分析2014年1月1日~2017年12月31日期间HIV/AIDS合并结核病患者的一般信息、临床表现及CD4^(+)T淋巴细胞计数水平及其与HIV/AIDS合并结核病的关系。结果2014~2017年本院5184例HIV/AIDS患者中1629例(31.42%)合并肺结核,246例(4.37%)合并肺外结核,568例(10.96%)同时合并肺结核及肺外结核,HIV/AIDS合并结核病共2443例(47.13%)。HIV/AIDS合并肺结核患者中,继发性肺结核1382例(84.84%)、血行播散性肺结核97例(5.95%),支气管结核32例(1.96%),结核性胸膜炎118例(7.24%)。HIV/AIDS合并肺外结核患者中,结核性脑膜炎91例(36.99%),淋巴结结核76例(30.89%),骨结核15例(6.10%),其他部位结核(肝结核、脾结核、腹腔结核、睾丸结核等)64例(26.02%)。HIV/AIDS同时合并肺结核及肺外结核患者中,继发性肺结核合并结核性脑膜炎156例(27.46%),继发性肺结核合并淋巴结结核103例(18.13%),血行播散性肺结核合并结核性脑膜炎50例(8.80%),血行播散性肺结核合并淋巴结结核20例(3.52%)。HIV/AIDS合并肺结核患者中,痰或支气管肺泡灌洗液(BALF)抗酸染色涂片阳性者369例(22.65%);HIV/AIDS合并肺外结核患者中,相关组织液涂片或病理活检阳性47例(19.11%)。HIV/AIDS合并肺结核、肺外结核、同时合并肺结核及肺外结核患者中均以CD4^(+)T淋巴细胞计数水平在50~200个/μl之间占比最多,不同类型结核病患者CD4^(+)T淋巴细胞计数占比比较,差异具有统计学意义(P<0.05)。HIV/TB初治患者1572例(64.35%)、复治患者871例(35.65%)。复治患者中,在2014~2017年间反复住院抗结核治疗2次382例(15.64%)、3次188例(7.70%)、4次96例(3.93%)、5次49例(2.01%)、6次37例(1.51%)、7次31例(1.27%)、≥8次88例(3.60%)。结论本院HIV/AIDS患者中合并结核病患病率较高,结核病原学阳性率较低,各类型�Objective To summarize the clinical typing of tuberculosis and human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)co-infection and analyze their features in the Eighth Affiliated Hospital of Xinjiang Medical University from 2014 to 2017.Methods The general information,clinical manifestations and CD4^(+)T lymphocyte count levels of HIV/AIDS patients with tuberculosis and their correlation with HIV/AIDS combined with tuberculosis between January 1,2014 and December 31,2017 were retrospectively analyzed.Results Among the 5184 HIV/AIDS patients in our hospital from 2014 to 2017,1629 cases(31.42%)were combined with pulmonary tuberculosis,246 cases(4.37%)were combined with extrapulmonary tuberculosis,and 568 cases(10.96%)were combined with both pulmonary and extrapulmonary tuberculosis,and a total of 2443 cases(47.13%)were combined with HIV/AIDS.Among HIV/AIDS patients with pulmonary tuberculosis,1382 cases(84.84%)had secondary tuberculosis,97 cases(5.95%)had hematogenous pulmonary tuberculosis,32 cases(1.96%)had bronchial tuberculosis,and 118 cases(7.24%)had tuberculous pleurisy.Among patients with HIV/AIDS combined with extrapulmonary tuberculosis,91 cases(36.99%)had tuberculous meningitis,76 cases(30.89%)had lymph node tuberculosis,15 cases(6.10%)had bone tuberculosis,and 64 cases(26.02%)had tuberculosis of other sites(liver tuberculosis,spleen tuberculosis,abdominal tuberculosis,and testicular tuberculosis).Among patients with HIV/AIDS combined with both pulmonary and extrapulmonary tuberculosis,156 cases(27.46%)had secondary tuberculosis combined with tuberculosis meningitis and 103 cases(18.13%)had secondary tuberculosis combined with lymph node tuberculosis;50 cases(8.80%)had hematogenous pulmonary tuberculosis combined with tuberculosis meningitis and 20 cases(3.52%)had hematogenous pulmonary tuberculosis combined with lymph node tuberculosis.Among patients with HIV/AIDS combined with pulmonary tuberculosis,369 cases(22.65%)had positive antacid smears of sputum or bronchoalveolar lavage

关 键 词：艾滋病病毒 艾滋病 结核病 临床分型 

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