【摘要】 [目的]了解结核病患者中人类免疫缺陷病毒(HIV)感染情况,以及HIV病毒感染合并结核病患者的临床特点。[方法]对2006年4月1日～2007年3月31日成都市城区3447例新发结核病患者采用HIV抗体ELISA法检测进行初筛试验,初筛试验阳性者进行确认检查。对确认HIV病毒感染并且合并结核病的患者进行临床分析。[结果]3447例患者中,确认HIV抗体阳性23例,阳性率6.7‰,男性20例,女性3例,平均年龄37.4岁,外来无业人员及民工17例(73.9%),外来经商2例(8.7%),本市户籍人员4例(17.4%)。23例HIV病毒感染者中,单纯肺结核患者12例(52.2%),肺结核合并肺外结核患者5例(21.7%),结核性胸膜炎患者2例(8.7%),肺外结核患者4例(17.4%)。23例患者中合并除结核病外其他机会性感染的患者13例(56.5%),合并结核病外其他机会性感染比率极显著高于同期住院结核病患者(P﹤0.01);PPD试验阳性率9.5%,极显著低于同期住院结核病患者(P﹤0.01);17例HIV病毒感染合并肺结核患者中2例(11.8%)患者痰查抗酸杆菌阳性,痰查抗酸杆菌阳性率显著低于同期住院肺结核患者(P﹤0.05),17例HIV病毒感染合并肺结核患者中14例(82.4%)患者X线胸片及胸部CT检查以非特异性改变为主,X线检查非特异性改变比率极显著高于同期住院肺结核患者(P﹤0.01)。[结论]HIV病毒感染合并结核病患者症状不典型,结核菌素试验阳性率低,合并机会性感染多见;HIV病毒感染合并肺结核时,患者X线表现均不典型,痰菌阳性率低,容易误诊,应引起临床医生重视。更多还原

【Abstract】 [Objective] To know human immunodeficiency virus(HIV)infection situation in tuberculosis patients and the clinical characters of HIV infected patients complicated with tuberculosis.Methods The anti-HIV of every new tuberculosis patients in urban districts of Chengdu City was tested by ELISA method first.There were 3 447 new patients tested from 2006-04-01 to 2007-03-31.If the result was positive,the patient must be determined by confirm test.The clinical characters of patients diagnosed as HIV infection and tuberculosis were analyzed.Results 23 cases’anti-HIV were positive in all 3 447 cases,and positive rate was 6.7‰.There were 20 male cases and 3 female cases.The average age was 37.4 years.There were 17 cases of migrant unemployed men and migrant workers(73.9%),2 cases of migrant businessmen(8.7%),and 4 cases with registered permanent residence in Chengdu City(17.4%).In 23 patients with HIV infection,there were 12 patients(52.2%)were diagnosed as pulmonary tuberculosis,5 patients(21.7%)pulmonary tuberculosis and extra-pulmonary tuberculosis,2 patients(8.7%)tuberculous pleurisy,and 4 patients(17.4%) extra-pulmonary tuberculosis.In 23 patients,there were 13 patients(56.5%)were diagnosed as other opportunity infection except tuberculosis and the infection rate was significantly higher than that of in-patients in the same period(P﹤0.01).The positive rate of PPD test was 9.5%,and the rate was significantly lower than that of in-patients in the same period(P﹤0.01).In 17 patients who were diagnosed as HIV infection and pulmonary tuberculosis,2 patients were smear-positive,and the rate of smear-positive was significantly lower than that of in-patients in the same period(P﹤0.05).In the 17 patients,14 patients(82.4%)had main non-typical X-ray and chest CT features,and the rate of non-typical features was significantly higher than that of in-patients in the same period(P﹤0.01).Conclusion Symptoms of patients diagnosed as HIV infection and tuberculosis are not characteristic.The positive rate of PPD test is low.The patients complicated with opportunity infection are common.Patients diagnosed as HIV infection and pulmonary tuberculosis have non-typical X-ray features and low smear-positive rate.Consequently making a wrong diagnosis is common.Physician should be alert the occurrence of HIV infection and tuberculosis.更多还原