【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。更多还原

【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.更多还原