艾滋病经高效抗逆转录病毒治疗后发生免疫重建综合征并发肺结核的临床特点研究

目的探讨分析艾滋病(AIDS)高效抗逆转录病毒治疗(HAART)后发生免疫重建综合征(IRS)并发肺结核的临床特点,提高诊治水平。方法对42例HAART后发生IRS并发肺结核患者的临床资料进行分析。结果(1)艾滋病HAART后发生IRS并发肺结核病例呼吸道症状较少(占26.2%,11/42),结核中毒症状也少见(占28.6%,12/42)。(2)肺部以结节性病变(占40.5%,17/42)及纵隔淋巴结肿大(占35.7%,15/42)为主,空洞性病灶发生率低(占19.0%,8/42),痰菌阳性率仅为19.0%(8/42)。结论艾滋病HAART后发生IRS并发肺结核临床表现不典型,诊断困难,经验性治疗有助于诊断。

Clinical Characteristics Research of Immune Reconstitution Syndrome Complicated with Pulmonary Tuberculosis in AIDS Patients after Highly Active Anti-retroviral Therapy

Objective To discuss and analyze the clinical character of pulmonary tuberculosis as a complication of immune reconstitution syndrome(IRS) developed after highly active antiretroviral therapy(HAART)in AIDS patients so as to improve the level of diagnosis and treatment.Methods The clinical data of 42 cases of pulmonary tuberculosis as a complication of IRS of AIDS.Results(1) The IRS patients with pulmonary tuberculosis complication of IRS had few symptoms in respiratory tract(11/42,accounting for 26.2%),and few toxic symptoms of tuberculosis(12/42,accounting for 28.6%).(2)The pulmonary nodules(17/42,accounting for 40.5%) and mediastinal lymphadenopathy(15/42,accounting for 35.7%) took the major proportion;the rate of cavity development was lower(8/42,accounting for 19.0%),and the positivity rate of sputum was only 19.0%(8/42).Conclusion The clinical manifestation of pulmonary tuberculosis as a complication in IRS of AIDS is not typical so that it is difficult for diagnosis,however empirical therapy is helpful.