66例艾滋病合并肺结核与单纯肺结核临床对照分析

目的:探讨艾滋病合并肺结核病的临床特征。方法:将诊治的艾滋病合并肺结核病并完成治疗及随访的66例患者作为观察组(A组),以同期住院的HIV(-)单纯肺结核患者72例为对照组(B组)进行回顾性分析。结果:A组痰抗酸杆菌阳性率7例,10.61%,显著低于B组,21例,29.17%(P=0.007);A组发热和体重下降较B组更常见,而咳嗽和咯血较B组少见;A组合并肺外结核较B组多见,A组淋巴系统较B组常发生结核病变,A组全身血液播散性结核病的发病率明显高于B组;肺结核的X线、CT表现为弥漫性浸润或粟粒性阴影的,A组多于B组,而A组影像学空洞率显著低于B组;抗痨疗效A组显著低于B组;外周CD4+T淋巴细胞数与结核严重程度相关。结论:HIV(+)/AIDS患者合并肺结核临床表现不典型,结核分枝杆菌检出率低,肺结核的X线、CT表现不典型,抗痨疗效较差。

Clinical cross-check analysis on pulmonary tubercuiosis of 66 patients with and without HIV(+)/AIDS

Objective To analyze the clinical feature of pulmonary tubercuiosis patients with HIV(+) /AIDS.Method The observation group(GroupA) was 66 cases of pulmonary tubercuiosis patients with HIV(+) /AIDS,who were admitted and followed up in my hospital from January 2008 to December 2010,the control group(GroupB) was 72 cases of pulmonary tubercuiosis patients without HIV(+) /AIDS admitted at same time.A retrospective cohort study was conducted between the two groups.Results The positive probability of sputum smear acid-fast bacilli(AFB) of groupA(7 patients,10.61%) was remarkably lower than that of group B(21 patients,29.17%,P=0.007);Pyrexy and weigh losing were more frequent in groupA than groupB,while coughing and hemop tysis were less frequent in groupA than groupB;The probability of extra-pulmonary TB in groupA was significantly higher than that of group B,the probability of lymph node TB in groupA was significantly higher than that of group B,the probability of massive blood-borne dissemination in groupA was significantly higher than that of group B;The cases of miliary and massive disseminated PTB in groupA were remarkably more than that of group B,the voidage of groupA was remarkably less than that of group B;Antituberculosis therapeutic effects of groupA were remarkably less than that of groupB.CD4 + cell count was correlative with tuberculosis severity.Conclusion The clinical presentations of pulmonary tubercuiosis patients with HIV(+) /AIDS are atypical,The frequency of M.tuberculosis is low,the X-ray and CT Manifestations of PTB are atypical,antituberculosis therapeutic effects are bad.