利福布汀联合抗病毒药物治疗艾滋病合并结核病的临床研究

Clinical Study of Rifabutin Combined with Antiviral in the Treatment of AIDS with Tuberculosis

目的:探究利福布汀联合抗病毒药物在治疗艾滋病合并结核病的临床效果。方法:将本院感染科在2014年1月至2015年12月期间收治的艾滋病合并肺结核患者80例作为本次研究对象,根据临床用药的不同分为观察组和对照组,两组患者各40例,观察组实施含福布汀的抗痨方案+含依菲韦伦或克力芝抗病毒方案,对照组实施含利福平的抗痨方案+含依菲韦伦抗病毒方案,两组患者均进行抗结核治疗和抗艾滋病毒治疗,观察两组患者抗结核疗效、抗病毒疗效以及总不良反应情况。结果:研究组在抗结核治疗有效率、痰检转阴率、肺部空洞闭合率及肺部病灶吸收明显高于对照组(P<0.05);两组患者治疗前的CD4+T淋巴细胞差异无统计学意义(P>0.05),在经过治疗后,两组患者的CD4+T淋巴细胞均有明显上升,且研究组明显高于对照组(P<0.05);研究组患者发生免疫重建炎症综合征情况以及总不良反应情况明显低于对照组(P<0.05)。结论:利福布汀联合抗病毒治疗肺结核合并的临床效果显著,可以有效提高患者的痊愈率,降低不良反应发生,减少免疫重建炎症综合征的发生,增加抗结核及抗病毒疗效。

Objective:To explore rifabutin combined with antiviral drug clinical effect in the treatment of AIDS with tuberculosis.Methods:80 AIDS patients with pulmonary tuberculosis admitted to our hospital from January 2014 to December 2015 were selected as the subjects of this study.According to the difference of clinical medication,they were divided into observation group and reference group.There were 40 cases in each group of two groups.The observation group was given the anti-tuberculosis regimen containing forbestine plus the anti-tuberculosis regimen containing efoviran or cleistogen,and the control group was given the anti-tuberculosis regimen containing rifampicin plus the anti-virus regimen containing efoviran.Both groups were given anti-tuberculosis and anti-HIV treatment.The anti-tuberculosis,anti-virus and total adverse reactions of the two groups were observed.Situation.Results:The effective rate of anti-tuberculosis treatment,negative rate of sputum examination,closure rate of pulmonary cavity and absorption of pulmonary lesions in the study group were significantly higher than those in the control group(P<0.05).There was no significant difference in the CD4+T lymphocyte between the two groups before treatment(P>0.05).After treatment,CD4+T lymphocytes in both groups were significantly higher than those in the control group(P<0.05).The incidence of immune reconstitution inflammatory syndrome and total adverse reactions in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Rifambutin combined with antiviral treatment of pulmonary tuberculosis with significant clinical effect,can effectively improve the cure rate of patients,reduce adverse reactions,reduce the incidence of immune reconstruction inflammatory syndrome,increase the anti-tuberculosis and antiviral efficacy.