人类免疫缺陷病毒(HIV)感染合并肺结核34例临床分析

The analysis of 34 cases with HIV positive and pulmonary tuberculosis

目的 分析人类免疫缺陷病毒阳性合并肺结核感染的临床表现 ,探讨诊断方法。方法 对117例人类免疫缺陷病毒阳性合并肺结核感染 34例的临床表现、胸部X线及其他实验室检查进行分析。结果 117例人类免疫缺陷病毒阳性合并肺核感染 34例 ,感染率 2 9.1%。共用注射器静脉吸毒是主要原因。中等度发热、咳嗽、盗汗、消瘦 ,部分病例伴咯血、呼吸困难等与结核中毒症状相似。胸部X线检查以继发性肺结核为主 6 1.8%。多重感染中主要为念珠菌感染。住院期间病死率 17.6 %,死因为呼吸功能衰竭和多脏器功能衰竭。抗结核治疗对改善病情有帮助。因表现复杂 ,临床误诊较高。结论 肺结核合并机会性感染尤念珠菌感染 ,流行病学资料有静脉吸毒行为 ,应作HIV抗体检查有利诊断。

Objective To investigate the clinical manifestation and diagnosis of HIV positive cases combined with pulmonary tuberculosis.Methods 117 HIV positive cases were examined by X-ray and other laboratory tests.Results 34 to 117 HIV positive cases had tuberculosis.The rate was 29.1%.The clinical manifestation included fever,cough,emaciation hemoptysis and dyspnea.The X-ray revealed that most pulmonary tuberculosis were Ⅲ type,the positive rate was 61.8%.The pulmonary tuberculosis cases with HIV positive sometimes combinated with other opportunity infections,such as candidiasis,the positiver rate was 37.5%.Conclusion HIV positive cases always are drug injection users.The pulmonary tuberculosis cases which with candidiasis or other opportuni infections should do HIV test.