艾滋病合并结核感染状况的调查分析——附18例临床观察

Research and analysis of the status of acquired immunodeficiency syndrome complicated with tuberculosis——observation of 18 clinical cases

目的调查分析艾滋病合并结核感染的状况,提高对艾滋病合并结核感染的认识,探讨艾滋病与结核病的相关性。方法对近几年在我院就诊的125例艾滋病患者的相关资料进行回顾性分析。结果①125例艾滋病患者中有18例发生结核菌感染,发病率14.4%。其中,99例成人艾滋病人有13例合并结核,发病率13.1%;儿童艾滋病26例,有5例发生结核感染,发病率19.2%。②18例合并结核感染的病人,有6例死亡,死亡率33.3%,其中儿童死亡2例,死亡率40%(2/5);成人死亡4例,死亡率30.8%(4/13)。③临床分型:肺外结核6例,占33.3%,其中淋巴结核4例,结核性腹膜炎和脑膜炎各1例;肺结核12例,占66.7%,其中,粟粒性肺结核6例(33.3%),浸润性肺结核5例(27.8%),结核性胸膜炎1例。④有9例病人进行了CD4+细胞数目检测,在(29～84)个/μL之间,均<100个/μL。结论艾滋病合并结核感染的发病率大约15%左右,发生血行播散型肺结核和肺外结核多见;结核是引起艾滋病机会性感染和死亡的主要疾病,而CD4+细胞数目和功能低下可能是最主要的原因。

Objective To improve the cognition of AIDS complicated with tuberculosis and explore their correlation on the research and analysis of the status.Method To analyze the data of 125 cases of AIDS since 2000.Results ①of 125 cases,18 cases were infected with tuberculosis（TB）,the incidence of TB was 14.4 %.②of 18 cases of AIDS complicated with TB,6 cases died,mortality was 33.3 %,among which,children was 40 %,adults was 30.8 %.③clinical type：of 18 cases,pulmonary TB were 12（in which,hematogenous disseminated TB were 6 cases,osmotic TB were 5 cases）;Extra-pulmonary TB were 6 cases（in which,tuberculous lymphadenitis were 4cases,cerebral TB and peritoneal TB was each one）.④9 cases had the CD4^＋ cell test,CD4^＋ cells were（29-84）/μL,all less than 100/μL.Conclusion The incidence rate of AIDS complicated with TB was about 15 %,hematogenous disseminated TB were common;TB was the primary disease which caused opportunistic infections and death in AIDS,in which the decrease of amount and funfction of CD4^＋ cell might be the most important factor.