【作者】 侯志丽； 白大鹏； 梅早仙； 陈怀永； 吴琦；

【Author】 Zhili Hou;Zaoxian Mei;Dapeng Bai;Huaiyong Chen;Qi Wu;Tianjin Haihe Hospital,department of tuberculosis,Department of basic medicine Tianjin Institute of Respiratory Diseases,Key Research laboratory for infections disease prevention for State Administration of Traditional Chinese Medicine;

【机构】 天津市海河医院结核科基础实验室天津市呼吸疾病研究所国家中医药管理局中医药防治传染病重点研究所；

【摘要】 目的通过总结HIV/TB双重感染患者的临床特点,进一步指导临床治疗。方法:回顾性分析2012.01-2016.10在我院住院诊疗的72例HIV/TB患者的资料,总结HIV/TB患者的临床特点,与无合并HIV的结核患者进行对比,分析PPD、T-TSPOT.TB、血沉、结核抗体、痰结核菌等各种检查手段的诊断阳性率的区别,及该类患者耐药的情况。结果我院HIV/TB双重感染患者的男:女=66:6,平均年龄为:44.5±14岁,临床症状不典型,继发性肺结核的比例最高,占62.5%(45/72),其次淋巴结结核占20.8%(15/72),血型播散型肺结核占9.7%(7/72),肠结核占15.3%(11/72),结核性胸膜炎占23.6%(17/72),总共肺外结核患者占59.7%(43/72);PPD、结核抗体、血沉阳性率低,T-SPOT、痰抗酸染色、痰液培养阳性率高,但是HIV/TB双重感染的结核抗体、血沉和无合并HIV的结核患者检查阳性率有统计学差异;HIV/TB双重感染患者的结核分枝杆菌的总耐药率为28.6%(8/28)。结论 HIV/TB双感染患者的症状不典型,各种检查的联合诊断在对于HIV/TB患者的早期诊断更有帮助,HIV/TB患者的耐药率高,治疗时应给与重视,使HIV/TB双重感染患者得到更好的控制。更多还原

【Abstract】 Objective:Explore the clinical feature for the tuberculosis patients co-infected with HIV to direct the clinical diagnosis and treatment.Methods:Retrospective analysis the 72 TB patients co-infected with HIV in our hospital from 2012.01-2016.10,make the clinical features comparison with the tuberculosis patients without HIV,assay the positive rate among different diagnosis examination including PPD,-TSPOT.TB、ESR、TB antibody、sputum examination for tuberculosis together with the drug tolerance situation.Results:Fort thetuberculosis patie nts co-infected with HIV in our hospital,M:F=66:6,average age:44.5±14 year,clinical manifestation is not typical,the secondary Pulmonary tuberculosis takes the highest rate as 62.5%(45/72),lymphoid tuberculosis takes the secondarily highest rate as 20.8%(15/72),military tuberculosis take the rate as 9.7%(7/72),intestinal tuberculosis is 15.3%(11/72),tuberculosis pleuritis is 23.6%(17/72),the extrapulmonary tuberculosis is 59.7%(43/72) totally;positive rate for PPD,tuberculosis antibody and ESR is low,positive rate for T-SPOT.TB and sputum anti-acid staining examination is high,while there is statistic difference in positive rate of tuberculosis antibody and ESR between HIV/TB patients and tuberculosis without HIV infection;The totally drug tolerance rate of mycobacterium tuberculosis is 28.6%(8/28) for the HIV/TB dual infection patients.Conclusion:the manifestation and symptom of HIV/TB co-infection patients is not typical,various co-examination can benefit the early diagnosis for the HIV/TB co-infection.And the more attention in treatment should be given to the HIV/TB co-infection patients due to the high drug resistant rate in order to control the dual infection better.更多还原