HIV(+)/AIDS并发肺结核与单纯肺结核患者临床对照分析

提高对HIV(+)/AIDS并发肺结核临床表现的认识。方法:选取1998年以来我院收治的HIV(+)/AIDS并发肺结核的病例共47例为观察组(A组),及同期住院的HIV(-)单纯肺结核病例50例为对照组(B组)进行回顾性对照分析。结果:(1)A组发烧和体重下降较B组更常见,而咳嗽和咯血较B组少见;(2)A组痰抗酸杆菌阳性率显著低于B组;(3)A组结核杆菌培养阳性率显著低于B组,而耐多药结核(MDR-TB)所占比率显著高于B组;(4)肺结核的X线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;(5)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;(6)PPD结核菌素反应阳性率A组显著低于B组,A组PPD阳性率与外周CD4+T淋巴细胞数相关。结论:HIV(+)/AIDS患者并发肺结核临床表现不典型。

Clinical Cross-Check Analysis on Pulmonary Tubercuiosis Patients with and without HIV(+)/AIDS

To enhance the cognition about clinical feature of pulmonary tubercuiosis patients with HIV( )/AIDS,the observation group(GroupA) was 47 cases of pulmonary tubercuiosis patients with HIV( )/AIDS,who were admitted in our hospital since 1998,the control group(GroupB) was 50 cases of pulmonary tubercuiosis patients without HIV( )/AIDS admitted at same time.A retrospective cohort study was conducted between the two groups.Pyrexy and weigh losing were more frequent in groupA than groupB,while coughing and hemoptysis were less frequent in groupA than groupB;The positive probability of sputum smear acid-fast bacilli(AFB) of groupA was remarkably lower than groupB;The positive probability of TB culture in groupA was remarkably lower than groupB;Ratio of multidrug-resistant TB in groupA was significantly higher than groupB;The cases of miliary and massive disseminated PTB in groupA were remarkably more than groupB,the voidage of groupA was remarkably less than groupB;The probability of extra-pulmonary TB in groupA was significantly higher than groupB,the probability of lymph node TB in groupA was significantly higher than groupB,the probability of massive blood-borne dissemination in groupA was significantly higher than groupB;PPD tuberculin positive probability of groupA was significantly lower than groupB,and was correlative with CD4 cell count.The clinical presentations of pulmonary tubercuiosis patients with HIV( )/AIDS are atypical.