艾滋病合并结核病的临床特征及相关性分析  

Clinical characteristics and correlation analysis of acquired immunodeficiency syndrome/tuberculosis

作　　者：古丽米拉·达列力汗 李弘 员银 石攀 齐曼古力·吾守尔[1] GULIMILA Dalielihan;LI Hong;YUN Yin(Respiratory Department,First Affiliated Hospital of Urumqi 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呼吸科,830013

出　　处：《中国实用医药》2022年第26期71-74,共4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：目的分析艾滋病合并结核病(AIDS/TB)的临床特征及相关性。方法回顾性分析686例AIDS/TB患者的一般资料、临床症状及肺部影像学资料,以电话问卷调查形式获得AIDS/TB患者有无高效抗逆转录病毒治疗(HAART)、HAART规律与否、药物不良反应、重视病情程度、对TB知识知晓程度、经济能力等,分析AIDS/TB的影响因素。结果AIDS/TB患者中,男487例(71.0%),女199例(29.0%);年龄<30岁59例(8.6%)、30~44岁412例(60.1%)、45~59岁184例(26.8%)、>60岁31例(4.5%);无业人员498例(72.6%)、学生3例(0.4%)、农民81例(11.8%)、离退休人员及自由职业者95例(13.8%),企事业单位职员9例(1.3%)。临床症状以咳嗽咳痰419例(61.1%)最多见,其次为乏力228例(33.2%)、发热163例(23.8%)、呼吸困难161例(23.5%)、咯血45例(6.6%)、病原学阳性77例(11.2%)。肺部影像学特征表现为单个肺叶渗出影133例(19.4%)、多个肺叶渗出影550例(80.2%)、空洞124例(18.1%)、胸腔积液116例(16.9%)。Logistic回归分析显示,HAART、HAART规律与否、药物不良反应、重视病情程度、对TB知识知晓程度、经济能力均为AIDS/TB患者的影响因素,且HAART、HAART规律是AIDS/TB患者的保护因素(OR=0.002、0.498,P<0.05),药物不良反应、不重视病情、对TB知识知晓程度低、经济能力差是AIDS/TB患者的危险因素(OR=243.555、110.882、66.221、168.294,P<0.05)。结论AIDS/TB患者以男性、无业、青壮年为主,规律的HAART是艾滋病患者发生TB的保护因素,需加强患者治疗依从性,提高治疗效果。Objective To analyze the clinical characteristics and correlation of acquired immunodeficiency syndrome/tuberculosis(AIDS/TB).Methods The general data,clinical symptoms and pulmonary imaging data of 686 patients with AIDS/TB were retrospectively analyzed;the factors influencing AIDS/TB were obtained in the form of telephone questionnaires on the presence or absence of highly active antiretroviral therapy(HAART),regularity of HAART or not,adverse drug reactions,importance of the disease,knowledge of TB,and financial ability.Results Among AIDS/TB patients,487 cases(71.0%)were male and 199 cases(29.0%)were female;59 cases(8.6%)were aged<30 years,412 cases(60.1%)were aged 30-44 years,184 cases(26.8%)were aged 45-59 years,and 31 cases(4.5%)were aged>60 years;498 cases(72.6%)were unemployed,3 cases(0.4%)were students,81 cases(11.8%)were farmers,95 cases(13.8%)were retired persons and freelancers,and 9 cases(1.3%)were employees of enterprises and institutions.The most common clinical symptoms were cough and sputum in 419 cases(61.1%),followed by malaise in 228 cases(33.2%),fever in 163 cases(23.8%),dyspnea in 161 cases(23.5%),hemoptysis in 45 cases(6.6%),and positive pathogenesis in 77 cases(11.2%).Pulmonary imaging features showed single lobe exudate shadow in 133 cases(19.4%),multiple lobe exudate shadow in 550 cases(80.2%),cavity in 124 cases(18.1%),and pleural effusion in 116 cases(16.9%).Logistic regression analysis showed that HAART,regularity of HAART or not,adverse drug reactions,importance of the disease,knowledge of TB,and financial ability were all influential factors for patients with AIDS/TB,and HAART and HAART regularity were protective factors for patients with AIDS/TB(OR=0.002,0.498;P<0.05),adverse drug reactions,ignorance of disease,low knowledge of TB,and poor financial ability were risk factors for AIDS/TB patients(OR=243.555,110.882,66.221,168.294;P<0.05).Conclusion AIDS/TB patients is predominantly male,jobless,and young adults.Regular HAART is a protective factor for the development of TB in AIDS p

关 键 词：艾滋病 结核病 临床特征 相关性 

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