艾滋病合并肺结核64例临床研究

目的 探讨艾滋病合并肺结核的临床特点及治疗.方法 对64例艾滋病合并肺结核患者资料进行分析研究.结果 64例患者人类免疫缺陷病毒(HIV)感染途径为静脉吸毒(79.7%)及性途径(18.7%).临床表现有持续发热(96.8%),咳嗽(81.2%),腹泻(32.8%),结核菌纯蛋白衍生物试验(PPD)试验阴性率78.1%,全身浅表淋巴结肿大(71.9%),胸部X线表现以继发性肺结核为主(65.6%),经抗结核及抗HIV病毒治疗,大部分患者症状体征及胸片改善.抗结核不良反应发生率高.结论 艾滋病合并肺结核常发病急,症状重,PPD试验阳性率低,抗结核药物治疗不良反应多,临床应尽可能同时进行抗结核与抗HIV病毒治疗,应提高艾滋病高发区及高危人群肺结核患者并发艾滋病的警惕性.

Clincal analysis of acquired immunodeficiency syndrome complicated with pulmonary tuberculosis in 64 patients

Objective To investigate the clinical characteristics of acquired immunodeficiency syndrome (AIDS) complicated with pulmonary tuberculosis (PTB) and the treatment.Methods Sixty-four inpatients diagnosed AIDS complicated with PTB were analyzed retrospectively.Results The route of infection in 64 HIV cases were intravenous injection of narcotic(79.7%) and sexual transmission(18.7%);the clinical presentations were fever(96.8%),cough(81.2%),diarrhea (33.8%),swelling of lymph node(71.9%) and the negative rate of PPD test was 78.1%.The common presentation of chest X-ray was secondary PTB(65.6%).After anti-TB and anti-HIV therapits,most of the symptoms,signs and X-ray presentations were improved.The rate of adverse reaction of anti-TB was higher.Conclusion AIDS complicated with PTB is often acute and critical,PPD test positive rate is higher.These patients should be treated with coincident anti-TB and anti-HIV therapies.It needs to enhance the rigilance for the PTB patients to be complicated with AIDS in HIV prevelance area and high risk population.