论文部分内容阅读
目的:总结高海拔地区艾滋病合并肺结核的临床特点,以便提高对其的认识。方法:选取我科2009年—2012年收治的艾滋病合并肺结核病例共30例为观察组(A组),2012年我科收治的单纯肺结核病例30例为对照组(B组)进行对比分析。结果:A组发热、体重减轻者所占比例,明显高于B组(P<0.01),而咳嗽、咯血及盗汗病例所占比例,低于B组(P<0.01或P<0.05);A组PPD试验阳性率及血结核抗体检测阳性率显著低于B组(P<0.01或P<0.05);A组痰找抗酸杆菌、痰结核杆菌培养阳性率显著低于B组(P<0.01);A组影像学表现纵膈淋巴结肿大、弥漫性浸润、粟粒性阴影病例所占比例多于B组(P<0.005),而合并空洞率显著低于B组(P<0.01);A组外周血CD3+T细胞值低于B组(P<0.05),CD8+T细胞值高于B组(P<0.05),CD4+T细胞值、CD4+/CD8+比值明显低于B组(P<0.01);A组合并肺外结核例数多于B组(P<0.01),且A组合并肺外结核率与CD4+T淋巴细胞计数相关。结论:高海拔地区艾滋病合并肺结核临床特征不典型,给临床诊治带来了一定的困难。
OBJECTIVE: To summarize the clinical features of HIV / AIDS-TB in high-altitude areas in order to improve their understanding. Methods: A total of 30 cases of AIDS-related pulmonary tuberculosis admitted to our department from 2009 to 2012 were selected as the observation group (A group). In 2012, 30 cases of simple pulmonary tuberculosis treated in our department were compared to the control group (B group). Results: The proportion of fever and weight loss in group A was significantly higher than that in group B (P <0.01), while the proportion of cough, hemoptysis and night sweats was lower than that in group B (P <0.01 or P <0.05). A The positive rate of PPD test and the positive rate of anti-TB antibody test in group B were significantly lower than those in group B (P <0.01 or P <0.05). The positive rate of sputum bacterium and sputum bacillus in group A was significantly lower than that in group B ). The imaging findings of group A showed more mediastinal lymphadenopathy, diffuse infiltration, and miliary shadow than those of group B (P <0.005), while the percentage of combined holes was significantly lower than that of group B (P <0.01). A The CD3 + T cells in peripheral blood were lower in group B than those in group B (P <0.05), CD8 + T cells in group B were higher than those in group B (P <0.05), and the ratio of CD4 + T cells and CD4 + / CD8 + <0.01). The number of extra-pulmonary tuberculosis in group A was more than that in group B (P <0.01), and the rate of extra-pulmonary tuberculosis in group A was correlated with CD4 + T lymphocyte count. Conclusion: The clinical features of HIV / AIDS complicated with tuberculosis in high altitude areas are not typical, which brings some difficulties in clinical diagnosis and treatment.