|本期目录/Table of Contents|

[1]范桂权,胥富波,漆 俊,等.HIV 感染合并结核病的临床特征及相关影响因素分析[J].传染病信息,2018,06:548-551554.
 FAN Gui-quan,XU Fu-bo,QI Jun,et al.Clinical features and relevant influencing factors of HIV infection combined with tuberculosis[J].Infectious Disease Information,2018,06:548-551554.
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HIV 感染合并结核病的临床特征及相关影响因素分析(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2018年06期
页码:
548-551554
栏目:
论 著
出版日期:
2018-12-30

文章信息/Info

Title:
Clinical features and relevant influencing factors of HIV infection combined with tuberculosis
作者:
范桂权胥富波漆 俊宋立江
615000 西昌,凉山彝族自治州第一人民医院普外科 (范桂权),传染科(胥富波、漆俊),放射科(宋立江)
Author(s):
FAN Gui-quan XU Fu-bo QI Jun SONG Li-jiang
Department of General Surgery, the First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang 615000, China
关键词:
人类免疫缺陷病毒结核病临床特征影响因素
Keywords:
human immunodeficiency virus tuberculosis clinical features influencing factors
分类号:
 R512.91;R521
DOI:
10.3969/j.issn.1007-8134.2018.06.013
文献标识码:
A
摘要:
目的 分析HIV 感染合并结核病(tuberculosis, TB)的临床特征,探索HIV 感染合并TB 的相关影响因素,为 临床防治提供依据。方法 350 例HIV 感染合并TB 的患者主要来源于凉山彝族自治州第一人民医院,部分来源于AIDS 高 发的县医院,另以分层抽样法抽取200 例单一HIV 感染者作为对照。收集患者人口学资料、临床表现统计资料、胸部X 线/CT 影像学资料及实验室检查资料,统计治疗情况、吸烟史、吸毒史、性病史、工作性质等,分析HIV 感染合并TB 的相关因 素。结果 HIV 感染合并TB 患者主要为已婚中年男性,文化程度低,多为农民。其中有吸烟史者占96.00%,静脉吸毒史 者占65.71%,性病史者占32.00%,冶游史者占28.29%。TB 以肺结核合并肺外结核为主,肺结核合并肺外结核患者CT 表 现中斑片或大片实变影、累及胸膜或淋巴结、纵隔内淋巴结增大、胸腔积液、心包积液及存在空洞的占比明显高于单 纯性肺结核(P 均< 0.05)。350 例患者中23.43% 的患者痰检涂阳,其余涂阴者经利福平耐药实时荧光定量核酸扩增系统 检测或TB-PCR 检测阳性,患者对利福平耐药率为18.86%;72.00% 的患者抗病毒治疗依从性良好,抗结核治疗治愈者91 例, 完成疗程者166 例,共占73.43%。Logistic 回归分析显示性别、年龄、文化程度、吸烟史、静脉吸毒史、性病史、冶游史、 近期CD4+ T 细胞计数均为HIV 感染合并TB 的危险因素(P 均< 0.05)。结论 凉山彝族自治州HIV 感染合并TB 患者的 临床特征复杂,治疗现状不乐观,其发病受性别、年龄、文化程度、吸烟史、静脉吸毒史、性病史、CD4+ T 细胞计数等多 种因素的影响,应加强本地区相关的宣教工作及防艾禁毒工作,并制定针对性防治策略。  
Abstract:
Objective To analyze the clinical features of HIV infection combined with tuberculosis (TB), explore the relevant influencing factors of HIV infection combined with TB, and provide clinical basis for clinical prevention and treatment of such infection. Methods Three hundred and fifty patients with HIV infection combined with TB were dominantly selected from the First People's Hospital of Liangshan Yi Autonomous Prefecture, and partly from county hospitals with a high incidence of AIDS. Another 200 cases of single HIV infection were selected by stratified sampling method, as control group. The demographic data, clinical manifestation statistical data, chest X-ray film / CT imaging and laboratory examination data of all patients were collected. Their treatment, smoking history, drug abuse history, history of venereal disease and work nature were statistically analyzed. Factors related to HIV infection combined with TB were also statistically analyzed. Results HIV-infected patients with TB were mainly married middle-aged men, their education level was low and their occupations mostly were farmers. The percentages of people having smoking history, having intravenous drug abuse history, having history of venereal disease and having history of visiting prostitutes were 96.00%, 65.71%, 32.00% and 28.29% respectively. The type of TB infection was mainly pulmonary tuberculosis plus extrapulmonary tuberculosis. CT scans of pulmonary tuberculosis patients with extrapulmonary tuberculosis, showing patches or large consolidation, involving pleural or lymph nodes, mediastinal lymph node enlargement, pleural effusion, pericardial effusion, and the cavities were obviously higher than those of simple tuberculosis patients (P < 0.05). Among the involved 350 patients, 23.43% of patients were sputum smear-positive, and the remaining negative cases was positive by Xpert MTB/RIF or TB-PCR, and the resistance rate to rifampicin of patients was 18.86%; 72.00% of patients had good compliance of antiviral therapy. Ninety-one patients were cured by anti-tuberculosis treatment and 166 cases had completed the course of treatment, accounting for 73.43%. Logistic regression analysis showed that gender, age, educational level, smoking history, history of intravenous drug abuse, history of venereal disease, history of visiting prostitutes, and CD4+ T cells count were regarded risk factors for HIV/TB infection (P < 0.05). Conclusions The clinical features of patients with HIV infection combined with TB in Liangshan Yi Autonomous Prefecture are complex. The treatment status is not optimistic and the incidence is influenced by many factors, such as gender, age, educational level, smoking history, history of intravenous drug abuse, history of venereal disease and CD4+ T cells count. It is necessary to strengthen the related propaganda and education, as well as drug control and AIDS prevention in this region, and formulate targeted control strategies.     

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备注/Memo

备注/Memo:
[ 基金项目] 凉山州科技局资助项目(15YYJS0008)
[ 作者单位] 615000 西昌,凉山彝族自治州第一人民医院普外科 (范桂权),传染科(胥富波、漆俊),放射科(宋立江)
更新日期/Last Update: 2018-12-30