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目的:分析HIV合并肺结核患者的临床特征及抗结核治疗的疗效。方法:将我院收治的HIV感染合并肺结核初治患者53例作为A组,将同期收治的单纯肺结核患者176例作为B组,对两组患者临床资料、实验室检查结果以及治疗效果等进行回顾性分析。结果:A组患者并发症发生率以及肺外结核发生率显著高于B组(P<0.05),A组咳嗽发生率低于B组,但发热发生率高于B组(P<0.05);A组患者斑点实验、PPD实验、痰查抗酸杆菌阳性率均低于B组(P<0.05),A组患者肝功能异常、肾功能异常以及CD4+计数<200发生率高于B组(P<0.05);A组抗结核治疗的临床疗效低于B组(P<0.05);两组患者治疗后CD4+水平均高于治疗前,且B组高于A组(P<0.05)。结论:与单纯感染肺结核的患者相比,HIV合并肺结核患者并发症以及肺外结核发生率较高,实验室相关检查敏感性较低,抗结核治疗的效果较差,临床应给予重视。
Objective: To analyze the clinical features of HIV combined with tuberculosis and the efficacy of anti-TB therapy. Methods: 53 cases of newly diagnosed pulmonary tuberculosis patients with HIV infection admitted to our hospital were enrolled in group A, 176 cases of simple pulmonary tuberculosis admitted in the same period were selected as group B, and the clinical data, laboratory test results and treatment effects of the two groups were reviewed Sexual analysis. Results: The incidence of complications and pulmonary tuberculosis in group A were significantly higher than those in group B (P <0.05). The incidence of cough in group A was lower than that in group B, but the incidence of fever was higher than that in group B (P <0.05). A group of patients with spot test, PPD test sputum check acid bacilli positive rate was lower than the B group (P <0.05), A group of patients with liver dysfunction, renal dysfunction and CD4 + count <200 incidence was higher than the B group (P <0.05). The clinical efficacy of anti-TB therapy in group A was lower than that in group B (P <0.05). The CD4 + levels in both groups were significantly higher than those before treatment, and in group B were higher than those in group A (P <0.05). Conclusion: Comparing with patients with pulmonary tuberculosis alone, the complication of tuberculosis and the extrapulmonary tuberculosis in HIV-infected patients are relatively low. The sensitivity of laboratory-related tests is low, and the effect of antituberculosis treatment is poor.