IPT对存在结核分枝杆菌感染的HIV感染者/AIDS患者的预防效果分析

Analysis on the preventive effects of IPT for patients with HIV infection/AIDS complicated with Mycobacterium tuberculosis infection

目的观察异烟肼预防性治疗(IPT)对存在结核分枝杆菌感染的人类免疫缺陷病毒(HIV)感染者/获得性免疫缺乏综合征(AIDS)患者的预防效果。方法选取61例明确存在结核分枝杆菌感染的HIV感染者/AIDS患者作为研究对象,根据其外周血CD4^+T淋巴细胞计数将其分为A组、B组和C组。三组患者均给予为期6个月的IPT治疗,对三组患者治疗前、后六个时间点的外周血CD4^+T淋巴细胞计数、CD8+T淋巴细胞计数进行检测和比较;对治疗后24个月内三组患者结核病发病情况和常规实验室检查指标进行观察和比较。结果三组患者外周血CD4^+细胞计数总体呈上升趋势,各时点间的差异和各组间的差异均有统计学意义(F=11.051、18.143,P=0.000);在随访期内,各组中均未见结核病发病病例;三组患者除治疗期间的外周血WBC、Lym水平的差异有统计学意义(F=6.237、4.475,P=0.04、0.016)外,其他常规实验室检查指标的差异均无统计学意义(F=0.234~1.806,P>0.05)。结论对于存在结核分枝杆菌感染的HIV感染者/AIDS患者应用IPT治疗,能够在一定程度上改善患者的免疫功能、预防结核病的发病,而且对于不同免疫功能水平的患者其安全性基本相当。

Objective To observe and analyze the preventive effects of Isoniazid Preventive Therapy （IPT） for patients with Human Immunodeficiency Virus（HIV） infection/Acquired Immune Deficiency Syndrome（AIDS） complicated with Mycobacterium tuberculosis infection. Methods 61 cases of the patients with HIV infection/AIDS complicated with Mycobacterium tuberculosis infection were selected as the research objects and divided into group A, group B and group C according to the CD4^＋T lymphocyte count in the peripheral blood. The patients in the three groups were treated with IPT for a period of 6 months. The peripheral blood T CD4^＋ lymphocyte count of the patients in the three groups at the time points before and after the treatment were detected and compared; The patients in the three groups were followed up for 24 months after the treatment, the incidence of tuberculosis and the routine laboratory indexes were observed and compared. Results The peripheral blood CD4^＋ T lymphocyte count of the patients in the three groups were observed as an overall upward trend, the difference between each time point and the differences among the groups were statistically significant（F=11.051,18.143, P=0.000）; In the follow-up period, no cases of tuberculosis were observed in each group. Excepted the differences of peripheral blood white blood cell count, lymphocytes count during the treatment were statistically significant（F=6.237,4.475, P=0.04,0.016）, the differences of other routine laboratory indexes among the three groups were statistically significant （F=0.234-1.806,P〉0.05）. Conclusion The application of IPT in treatment of patients with HIV infection/AIDS complicated with Mycobacterium tuberculosis infection can improve the immune function of the patients and prevent the incidence of tuberculosis in a certain extent. Meanwhile, for the patients with different immune function levels, its safety is basically qual.