艾滋病合并肺结核129例临床分析

目的　提高对艾滋病合并肺结核的认识。方法 对 1998—2003年收治的 129例艾滋病合并肺结核进行分析。结果 HIV感染途径 :静脉吸毒史 80例,性乱史 25例,静脉吸毒加性乱史 18例。临床表现 :发热 (86.8%)、消瘦 (76%)、全身酸痛、乏力 (74.4%)、浅表淋巴结肿大 (30.2%)、腹泻(21.7%)、皮肤搔痒 (20%)等常见。胸部X线以粟粒性病变、中下肺野浸润、肺门或纵膈淋巴结肿大及胸膜炎多见。 37.2%患者同时合并丙肝抗体阳性,5.4%合并梅毒抗体阳性。经抗结核治疗后,大部分病人症状体征及胸片改善。结论 临床医师应重视AIDS流行的现实,对发热伴X线不典型肺结核患者,应常规检测HIV抗体及HCV抗体,短程抗结核化疗对本病较为安全有效。

Clinical analysis of 129 cases suffer from AIDS with pulmonary tuberculosis

Objective To improve the awareness of AIDS with pulmonary tuberculosis.Methods 129 cases suffered from AIDS with pulmonary tuberculosis from 1998 to 2003 were analyzed.Results Infection means of in 80 cases infected by narcotic taking by blood vein.25 cases by sexual,18 cases by both ways.Common clinical presentations were fever (86.8%),weight loss (76%),pantalgia and asthenia (74.4%),lymphnodes tumour (30.2%),diarrhea (21.7%),skin itching (20%) and so on.Chest X-ray showed military tuberculosis,lung infiltration,pulmonary hilar or mediastinal lymphnodes tumour and pleuritis.37.2% with HCV antibody positive,5.4% with syphilis serum antibody positive.The clinical symptoms,signs and chest X-rays were improved after anti-tuberculosis therapy in most of the patients.Conclusion Physician should be alert of the occurrence of AIDS with pulmonary tuberculosis.HIV antibody and HCV antibody should be detected routinely for tuberculosis cases with atypical radiographic complicated fever.The short course anti-tuberculosis chemotherapy is effective for AIDS with pulmonary tuberculosis.