艾滋病合并结核病87例临床分析

目的探讨艾滋病合并结核病的临床特点。方法选择2004年1月至2009年10月本院收治的87例艾滋病合并结核病患者,回顾性分析患者的临床表现、实验室检查结果、治疗及转归。结果87例患者的临床特点:多为青壮年(87.4%),男性多发(4.8∶1),年龄跨度大。临床症状:发热71例(81.6%),以持续高热为主;咳嗽咳痰65例(74.7%),气促20例(23.0%),腹痛、腹泻15例(17.2%),消瘦51例(58.6%),浅表淋巴结肿大19例(21.8%);低蛋白血症、电解质紊乱、血细胞沉降率和C反应蛋白升高、外周血白细胞和淋巴细胞下降较常见。结论艾滋病合并结核病患者临床表现复杂多样,淋巴结核常见,肺部病灶影像表现无特征性,结核菌素试验阳性率低,CD4+细胞明显降低,易合并多种机会感染,常发生并发症。

The Clinical Analysis of 87 Patients with AIDS Combined Tuberculosis

Objective To study the clinical features of AIDS combined tuberculosis.Methods Retrospectly analyse the clinical appearance,laboratory results,treatment and outcomes of 87 patients with AIDS complicated tuberculosis,who were admitted to our hospital from January 2004 to October 2009.Results The clinical features of 87 patients with AIDS complicated tuberculosis:majority of the patients were the young adults(87.4%),male-dominated(4.8∶1),and their ages spanned large.Common clinical symptoms were fever 71 cases(81.61%),majority of persistent high fever,cough andexpectoration65cases(74.7%),shortness of breath in 20 cases(23.0%),abdominal pain,diarrhea in 15 cases(17.2%),wasting in 51 cases(58.6%),superficial lymphadenectasis in 19 cases(21.8%).Hypoalbuminemia,electrolyte disorders,the values of ESR and C-reactive protein higher,peripheral blood leukocytes and lymphocytes decreased were frequently seen.Conclusion The clinical manifestations of the patients with AIDS combined tuberculosis showed complex and diverse and crewels is always seen in many patients.The manifestations of pulmonary imagery in these patients was no characteristic.The positive rate of tuberculin skin test was lower,the CD4+ T lymphocyte counts decreased significantly and a variety of opportunistic infections and complications were more common in these patients.