艾滋病合并结核病的临床分析  

Clinic analysis on cases of acquired immunodeficiency syndrome with tuberculosis

作　　者：王卫华[1] 赵恒敏 张和武[1] 

机构地区：[1]华中科技大学同济医院,武汉430030 [2]武汉市商业职工医院,武汉430021

出　　处：《中国防痨杂志》2003年第5期316-317,328,共3页Chinese Journal of Antituberculosis

摘　　要：目的　探讨艾滋病合并结核病的临床特点。方法　对 1998年至 2 0 0 2年 11例艾滋病合并结核病进行临床分析。结果　 (1)艾滋病感染途径 :输血感染者 8例 ,其他途径各 1例。 (2 )合并肺结核病 6例 ,其中继发性肺结核 3例 ,原发性肺结核 1例 ,血行播散性肺结核 2例 ;合并肺外结核 5例 ,其中结核性心包积液、结核性脑膜炎各 2例 ,胸腔积液 1例 ;合并多重感染者 5例。 (3) 11例1:2 0 0 0PPD试验均为阴性。 (4)治疗 :7例抗病毒与抗结核联合治疗 ,临床表现明显改善 ;3例仅抗结核治疗者中 1例有效、2例死亡 ;1例未经任何治疗 ,6月死亡。结论　艾滋病合并结核病临床表现多样 ,血行播散性肺结核多 ,肺外结核多 ,多重感染多见 ,抗病毒与抗结核联合治疗有效。Objective To determine the clinical characters of acquired immunodeficiency syndrome (AIDS) complicated with tuberculosis cases.Methods 11 AIDS complicated with tuberculosis cases from 1998 to 2002 were analyzed.Results (1)Transmission route:8 cases (73%) were infected by transfusion.(2)Clinical type:6 cases (54.6%) were diagnosed as AIDS complicated with pulmonary tuberculosis.Among those 6 cases,3 cases were infiltrating pulmonary tuberculosis,1 case was primary pulmonary tuberculosis,2 cases were disseminated tuberculosis.5 cases (45.4%) were diagnosed as AIDS complicated with extra-pulmonary tuberculosis.Among of those 5 cases,2 cases were tubercular pericardial effusion,2 cases were tuberculous meningitis and 1 case was tubercular pleural effusion case.5 cases (45.4%) were with multi-infections.(3)PPD test:The results of 1∶2000 PPD tests were negative of 11 cases.(4)Treatment:Clinical manifestations were found improved obviously in 7 cases that received treatment with anti-tuberculosis and anti-retrovirus treatments.Among 3 patients that received anti-tuberculosis treatment only,Clinical manifestations were found improved obviously in 1 case,2 cases died.1 case without any treatment died after 6 months.Conclusion The most cases were infected from transfusion.Among AIDS complicated with tuberculosis,circulating disseminated tuberculosis and extra-pulmonary tuberculosis were common and usually combined with other various opportunistic infection,clinical manifestations were complex.There was no meaning of PPD test for diagnose AIDS with tuberculosis.The combined anti-tuberculosis and anti-retrovirus treatments were efficient to cases of AIDS with tuberculosis.

关 键 词：艾滋病 合并症 结核病 临床特点 感染途径 

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