123例艾滋病合并肺结核的临床分析

The Clinical analysis of 123 AIDS Pantients associated with pulmonary tuberculosis

目的探讨艾滋病合并肺结核的临床特点及治疗方法。方法总结123例艾滋病合并肺结核患者的临床资料。结果123例患者均为青壮年人。平均年龄31岁,无业67例(54%)。感染途径:静脉注射毒品92例(75%),性乱史18例(15%),不详13例(11%)。临床特点:发113热例(82%),消瘦112例(91%),全身酸痛,乏力,纳差121例(98%),咳嗽118例(96%),咳痰107例(87%),腹泻38例(31%),浅表淋巴结肿大37例(30%)。X线特点:双肺与中下肺叶浸润病灶为主,肺门纵膈淋巴结肿大,急性血播,薄壁空洞型肺结核并支气管播散病灶与胸膜炎病人多见。合并丙型肝炎34例(28%),乙型肝炎9例(7%),梅毒4例(3%),带状疱疹7例(6%)。经抗结核治疗后患者症状、体征、胸片病灶明显好转,部分痰涂片转阴。结论艾滋病合并肺结核常发病急,症状重,原有结核病特点不典型。临床医师应重视艾滋病合并肺结核的临床特点,X线特点。抗结核治疗对本病较为安全。对肺结核,HCV感染等,带状疱疹病人应常规监测HIV抗体。

Objective Discussion of AIDS associated with tuberculosis in the clinical featueres and treatment.Methods The clinical analysis of the 123 cases of AIDS-associated with tuberculosis patinenets.Results 123 cases were young and middle-aged patients,the average age of in July 1998-2008 of them are 31 years old,67 cases （54%）.Path of infections IVDV use 92 cases （75%）.Clinicalfeatures：fever（92%）,weightless（91%）,pain,fatigue,anorexia（98%）,cough （96%）,expectoration （87%）,diarrhea （31%）.Superficial lymphadeno-pathy （30%）.X-ray features：infiltrative tuberculosis,lung infiltration,the middle and lower lobe lesions are common,mainly about Thin-walled caviar pulmonary tuberculosis and bronchial lesions disseminated,Hilary and mediastinal lymph nodes pleurisy,mostly patients with acute blood sowing.Combined hepatitis C （28%）,hepatitis B （7%）,syphilis （3%）,and herpes zoster （6%）.By most patients after treatment of anti-tuberculosis symptoms,signs,chest lesions improved significantly,some patients with negative sputum smear.Conclusions AIDS-associated tuberculosis in often acute and severe symptoms,the original characteristics of atypical tuberculosis are not special.Great importance to clinical of AIDS-associated tuberculosis in the clinical feature＇ s-ray features.Anti-tuberculosis treatment of this disease is safer.Tuberculosis,HCV,herpes zoster patients and routine monitoring HIV antibodies.