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低蛋白血症对HIV阳性肺结核患者T细胞亚群及临床特征的影响
Effects of hypoproteinemia on T cell subsets and clinical features in HIV-positive patients with pulmonary tuberculosis
【摘要】 目的 分析低蛋白血症对HIV阳性肺结核患者的T细胞亚群、临床表现、影像学特征及治疗反应的影响。方法 比较病例组32例HIV阳性肺结核合并低蛋白血症患者与对照组32例HIV阳性肺结核白蛋白正常患者的T淋巴细胞亚群、临床特征、影像学特点、抗结核治疗6个月病灶吸收程度和不良反应发生情况。结果 病例组T淋巴细胞CD3~+(Z=3.28,P<0.05)、CD4~+(Z=3.27,P<0.05)T细胞计数明显低于对照组;病例组发热(χ~2=11.13,P<0.05)、咳嗽(χ~2=4.95,P<0.05)、疲劳气促(χ~2=5.11,P<0.05)、体重下降(χ~2=5.08,P<0.05)比率明显高于对照组;病例组胸部CT出现胸腔积液和(或)心包积液(χ~2=9.04,P<0.05)、多叶病变(χ~2=4.27,P<0.05)的比率明显高于对照组;抗结核治疗6个月病例组胸部CT病灶显著吸收(χ~2=9.41,P<0.05)比率明显低于对照组;治疗过程病例组发生消化道反应(χ~2=9.97,P<0.05)、药物性肝损伤(χ~2=7.73,P<0.05)及其他药物不良反应(χ~2=25.00,P<0.05)比率明显高于对照组。结论 低蛋白血症可能导致HIV阳性肺结核患者的免疫力降低、临床症状加重,影响病灶吸收,导致抗结核治疗过程不良反应增多,不利于病情控制。
【Abstract】 Objective To analyze the effect of hypoproteinemia on T cell subsets, clinical features, imaging characteristics and treatment response in patients with HIV-positive pulmonary tuberculosis.Methods T lymphocyte subsets, clinical features, imaging characteristics, the degree of lesion absorption and the occurrence of adverse reactions after 6 months of anti-tuberculosis treatment were compared between 32 HIV-positive tuberculosis patients with hypoproteinemia in the case group and 32 HIV-positive tuberculosis patients with normal albumin level in the control group.Results The T lymphocyte CD3~+(Z=3.28,P<0.05) and CD4~+(Z=3.27,P<0.05) cell counts in the case group were significantly lower than those in the control group.The rates of fever(χ~2=11.13,P<0.05),cough(χ~2=4.95,P<0.05),fatigue shortness of breath(χ~2=5.11,P<0.05) and weight loss(χ~2=5.08,P<0.05) in the case group were significantly higher than those in the control group.The rate of pleural effusion and/or pericardial effusion(χ~2=9.04,P<0.05) and multilobed lesions(χ~2=4.27,P<0.05) in chest CT pulmonary lesions in the case group was significantly higher than that in the control group.The rate of significant absorption of chest CT lesions in the 6-month-old antituberculosis group(χ~2=9.41,P<0.05) was significantly lower than that in the control group. During the treatment, the incidence of digestive tract reaction(χ~2=9.97,P<0.05),drug-induced liver injury(χ~2=7.73,P<0.05) and other adverse drug reactions(χ~2=25.00,P<0.05) in the case group were significantly higher than those in the control group.Conclusion Hypoproteinemia may reduce the immunity of HIV-positive pulmonary tuberculosis patients, aggravate the clinical symptoms, affect the absorption of lesions, and increase the adverse reactions during treatment, which is not conducive to the control of the disease.
【Key words】 Hypoproteinemia; HIV-positive pulmonary tuberculosis; T-cell subsets; Clinical characteristics; Correlation; Analysis;
- 【文献出处】 医学动物防制 ,Journal of Medical Pest Control , 编辑部邮箱 ,2023年04期
- 【分类号】R521
- 【下载频次】42