艾滋病合并非结核分枝杆菌病患者的临床特征分析  

Analysis of Clinical Characteristics of Patients with AIDS Complicated by Nontuberculous Mycobacteriosis

作　　者：刘彪 Liu Biao(Guiyang Public Health Clinical Center,Guiyang,Guizhou 550000)

机构地区：[1]贵州省贵阳市公共卫生救治中心,贵州贵阳550000

出　　处：《科技与健康》2025年第3期81-84,共4页Technology and Health

摘　　要：分析艾滋病合并非结核分枝杆菌病患者的临床特征。选取2021年5月—2023年5月贵州省贵阳市公共卫生救治中心收治的53例艾滋病合并非结核分枝杆菌病患者的临床资料进行回顾性分析。分析结果显示,9例为抗逆反转录病毒治疗(anti-retroviral therapy,ART)初治,44例为经治,其中15例发生免疫重建炎症综合征(immune reconstruction inflamatory syndrome,IRIS)。患者的临床表现多样,包括发热、咳嗽、胸闷、乏力及食欲缺乏、四肢关节疼痛、肛门肿物等,且易混合其他机会性感染或疾病,如耶氏肺孢子菌、结核病、马尔尼菲蓝状菌病、隐球菌性脑炎病等。肺泡灌洗液(bronchoalveolar lavege fl uid,BALF)抗酸杆菌阳性12例,mNGS检出多种分枝杆菌12例。影像学主要表现为双肺多发斑片及实变影,共17例。研究发现,艾滋病合并非结核分枝杆菌病无特征性表现,且易并发机会感染,尤其在ART治疗前难以鉴别,导致诊断难度增大。临床医生需加强学习,通过将传统检测方法与mNGS技术相结合以提高诊断阳性率,并据此优化诊疗策略。This study aims to analyze the clinical characteristics of patients with AIDS complicated by nontuberculous mycobacteriosis.The clinical data of 53 patients with AIDS complicated by nontuberculous mycobacteriosis admitted to Guiyang Public Health Clinical Center from May 2021 to May 2023 were retrospectively analyzed.The analysis results showed that 9 patients were newly treated with anti-retroviral therapy(ART),and 44 patients had been treated.Among them,15 patients developed immune reconstruction inflammatory syndrome(IRIS).The clinical manifestations of the patients were diverse,including fever,cough,chest tightness,fatigue,poor appetite,pain in the extremities and joints,anal mass,etc.,and they were prone to be mixed with other opportunistic infections or diseases,such as Pneumocystis jirovecii,tuberculosis,Talaromycosis marneff ei,cryptococcal encephalitis,etc.There were 12 cases with positive acid-fast bacilli in bronchoalveolar lavage fl uid(BALF),and 12 cases in which multiple mycobacteria were detected by metagenomic next-generation sequencing(mNGS).The main imaging manifestations were multiple patchy and consolidative shadows in both lungs,with a total of 17 cases.The study found that AIDS complicated by nontuberculous mycobacteriosis has no characteristic manifestations and is prone to be complicated by opportunistic infections,especially it is diffi cult to diff erentiate before ART treatment,resulting in an increased diffi culty in diagnosis.Clinicians need to strengthen their learning,combine traditional detection methods with mNGS technology to improve the positive diagnosis rate,and optimize the diagnosis and treatment strategies accordingly.

关 键 词：艾滋病 非结核分枝杆菌 肺泡灌洗液 鸟分枝杆菌 抗酸杆菌 

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