51例HIV/AIDS合并支气管结核的支气管镜结果分析

Analysis of bronchoscopic findings of 51 cases with HIV/AIDS combined with endobronchial tuberculosis

目的总结人类免疫缺陷病毒（HIV）/获得性免疫缺乏综合征（AIDS）合并支气管结核（EBTB）患者的支气管镜下特点,提高临床诊断率。方法回顾性分析2010年1月~2014年12月长沙市第一医院51例经支气管镜确诊的HIV/AIDS合并EBTB患者的检查结果。结果 51例患者中,支气管镜下累及左主支气管17例（33.34%）,累及右主支气管4例（7.84%）,两个以上部位支气管受累达41.76%。本组患者以溃疡坏死型占首位（64.71%）,病变范围广泛者达40.2%,镜下分型最常见的是溃疡坏死型（Ⅱ型,33例,64.71%）和炎症浸润型（Ⅰ型,12例,23.53%）。结论 HIV/AIDS合并EBTB以青年男性多见,支气管镜下改变具有多发性,左肺病变多于右肺,以活动性病变（Ⅰ型、Ⅱ型）为主,各型病变常重叠存在。

Objective To summarize the bronchoscopic characteristics of patients with HIV/AIDS combined with endobronchial tuberculosis（EBTB）, in order to increase the diagnosis rate. Methods Inspection results of 51 cases of patients with HIV/AIDS combined with EBTB diagnosed by bronchoscopic in the First Hospital of Changsha from January 2010 to December 2014 were analyzed retrospectively. Results In the 51 cases of patients, the lesions of 17cases（33.34%） involved in the left principal bronchus, 4 cases（7.84%） involved in the right principal bronchus, lesions of 41.76% of patients had involved in more than two areas. Anabrosis necrotic（64.71%） was the typical type among all the patients, the wide range of lesions reached 40.2%. Endoscopic classification showed that anabrosis necrotic type（typeⅡ, 33 cases, 64.71%） and inflammatory infiltration type（type Ⅰ, 12 cases, 23.53%） were the commonest types.Conclusion HIV/AIDS combined with endobronchial tuberculosis has a predilection for males, bnronchoscopy microscopic changes has multiple, the lesions in the left lung are more than the right lung, mainly shows active lesions（typeⅠ, type Ⅱ）, various lesions often overlap exist.