HIV/AIDS患者预防和治疗结核病的研究

Research on prevention and treatment against tuberculosis in HIV/AIDS patients

目的 :调查艾滋病病毒 (HIV) /艾滋病 (AIDS)患者结核菌素 (PPD)试验反应状况及与免疫系统受损程度的联系 ,并探讨其预防和治疗结核病的意义。方法 :采用前瞻性病例对照研究方法 ,对 40例HIV /AIDS患者和 2 0 2例健康者做结核菌素试验 ,并对HIV/AIDS患者做CD4、CD8细胞计数测定 ,对HIV/AIDS患者分组服药 ,观察胸部病变及结核发生情况。结果 :HIV/AIDS患者与健康者PPD阳性率分别为 12 .5 %、2 8.2 % ,差异有显著性意义 ( χ2 =4.3 3P <0 .0 5 )。当CD4细胞计数下降时 ,PPD反应减弱。CD4<2 0 0个 /mm3 时PPD均无反应 ( 0× 0 )。病例服药组经化学药物预防治疗后其肺部病变异常率及结核的发病率小于病例对照组。结论 :HIV/AIDS患者PPD阳性率显著低于健康者。CD4细胞数下降可能是艾滋病并发结核的主要原因。对HIV/AIDS患者使用化学药物预防和治疗结核有效 ,同时为制定相关政策提供了依据。

Objective: To investigate the association between immune response and tuberculin test and its meaning for research on prevention and treatment against tuberculosis in HIV/AIDS patients. Methods: The prospective study was applied. Forty HIV/AIDS patients and 202 healthy were observed. Tuberculin test, CD 4?CD 8 cell counts were observed .It were examined for pulmonary tuberculosis condition in therapy and control groups of HIV/AIDS. Results: 12.5% of HIV/AIDS patients were PPD positive, while 28.2% of healthy were PPD positive(P<0.05). PPD reaction decreased when CD 4 cell counts were decreased . PPD test of CD 4 cell<200 were not positive (0×0mm). Pulmonary abnormal rate and tuberculosis incidence rate in therapy group were less than in the control group . Conclusion: PPD reaction in HIV/AIDS patients was significantly lower than health. The decrease of CD 4 cell might be important reason in AIDS with tubercuiosis .Chemical therapy was effective for prevention and treatment against tuberculosis in HIV/AIDS patients. These results are useful for making relative health policy.