HIV合并肺结核与单纯肺结核的临床特征分析及抗结核治疗效果对比

Analysis of Clinical Features of HIV and Non HIV Infected Pulmonary Tuberculosis and Effects of Anti Tuberculosis Treatment

目的:分析HIV合并肺结核患者的临床特征及抗结核治疗的疗效。方法:将我院收治的HIV感染合并肺结核初治患者53例作为A组,将同期收治的单纯肺结核患者176例作为B组,对两组患者临床资料、实验室检查结果以及治疗效果等进行回顾性分析。结果:A组患者并发症发生率以及肺外结核发生率显著高于B组(P<0.05),A组咳嗽发生率低于B组,但发热发生率高于B组(P<0.05);A组患者斑点实验、PPD实验、痰查抗酸杆菌阳性率均低于B组(P<0.05),A组患者肝功能异常、肾功能异常以及CD4+计数<200发生率高于B组(P<0.05);A组抗结核治疗的临床疗效低于B组(P<0.05);两组患者治疗后CD4+水平均高于治疗前,且B组高于A组(P<0.05)。结论:与单纯感染肺结核的患者相比,HIV合并肺结核患者并发症以及肺外结核发生率较高,实验室相关检查敏感性较低,抗结核治疗的效果较差,临床应给予重视。

Objective：To study the clinical characteristics of HIV and non HIV infected pulmonary tuberculosis and effects of anti tuberculosis treatment.Methods：53 cases with HIV complicated with pulmonary tuberculosis who were treated in our hospital were selected as group A,and another 176 cases with pulmonary tuberculosis were chosen to be group B.Then the clinical data,laboratory examination,imaging findings and treatment effects between the two groups were retrospectively analyzed.Results：The incidence of HIV complicated with pulmonary tuberculosis and pulmonary tuberculosis only of patients in group A were significantly higher than those of group B （P〈0.05）.The incidence of cough in group A was lower than that of group B,while the incidence of fever in group A was higher than that of group B （P〈0.05）.The positive rate of dot assay,PPD assay and sputum acid fast bacilli in group A were significantly lower than those of group B （P〈0.05）;The incidence of abnormal liver functions and renal functions and the CD4＋ counts that lower than 200 in group A were significantly higher than those of group B （P〈0.05）.The clinical efficacy of anti tuberculosis treatment in group B was significantly better than that of group A （P〈0.05）.The levels of CD4＋ in the two groups after treatment were significantly higher than before,and the group B was higher than that of group A （P〈0.05）.Conclusion：Compared with the patients with pulmonary tuberculosis,the incidence of extrapulmonary tuberculosis of patients with pulmonary tuberculosis complicated with HIV infection was higher the sensitivity of related laboratory examinations was lower,and the efficacy of anti tuberculosis treatment was less obvious,which may be required to be attention.