【摘要】 目的探讨液体培养在我国HIV感染者与AIDS患者结核病早期诊断中应用的可行性,为Mtb与HIV双重感染的防治提供参考。方法实验组选取安徽、河南、新疆、广西、云南5个省、自治区中开展中国全球基金结核病项目Mtb与HIV双重感染防治工作的10个地市(实际纳入8个地市),在新发现和既往可随访的15 199例HIV感染者与AIDS患者中选取符合条件的2162例进行液体培养,记录相关结果信息,并与同期收集的同地区全部15 199例和全国67 186例HIV感染者与AIDS患者(对照组)通过常规结核病检查方法获得的结核病诊断率进行比较。结果实验组样本阳性率14.2%(306/2162),明显高于同地区同期总体结核病诊断率5.2%(793/15 199),差异有统计学意义(χ2=254.9,P<0.0001);实验组阳性率(14.2%)与同地区总体结核病诊断率(5.2%,793/15 199)也都分别高于全国同期HIV感染者与AIDS患者的结核病诊断率(2.3%,1525/67 186),差异均有统计学意义(χ2=1150.7、393.8,P值均<0.0001)。结论液体培养与结核病症状筛查、痰涂片和X线胸片检查等常规结核病检查方法相比,可以显著提高HIV感染者与AIDS患者的结核病检出率,对于HIV感染者与AIDS患者的结核病早期诊断有着重要意义,适合在我国进行推广。更多还原

【Abstract】 Objective To explore the feasibility of the application of liquid culture in the early diagnosis of TB in patients living with HIV/AIDS,and provide a reference for Chinese Mtb/HIV co-infection prevention and treatment.Methods We selected 10 cities(8 enrolled eventually) from 5 provinces of Global Fund Mtb/HIV control Program,provided liquid culture screening for 2162 eligible cases within 15199 new findings and previous fo-llow-up of HIV/AIDS patients,recorded the results and compared the TB diagnosis rate with the whole 15199 patients in the same place and national 67186 cases of HIV/AIDS patients during the same period screened by routine tuberculosis screening methods.Results The positive TB diagnosis rate of experimental group’s samples was 14.2%(306/2162),which is significantly higher than the overall rate(5.2%,793/15199) of the same area over the same period,the difference was statistically significant(χ2=254.9,P<0.0001);also,the positive TB diagnosis rate of the experimental group(14.2%)and overall TB diagnosis rate of the same area(5.2%,793/15199)were both higher than the tuberculosis diagnosis rate in HIV/AIDS patients of whole country(2.3%,1525/67186),the difference was statistically significant(χ2=1150.7,393.8;P both<0.0001).Conclusion Compared with tuberculosis symptomatic screening,sputum smear,chest X-ray examination and other routine tuberculosis screening me-thods,liquid culture can significantly improve the TB detection rate in HIV/AIDS patients,which is very important for early TB diagnosis in HIV/AIDS patients and is of great significance to be promoted nationwide.更多还原