中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
35期
47-48
,共2页
艾滋病%合并%结核病%临床特点
艾滋病%閤併%結覈病%臨床特點
애자병%합병%결핵병%림상특점
Aids%Complicated%Tuberculosis%Clinical characteristics
目的：总结艾滋病合并结核病临床特点，以降低漏诊，提高临床疗效。方法：2010年2月-2014年7月收治艾滋病合并结核病患者80例，所有患者均进行ELISA法查HIV抗体监测，并经上级确诊，实验室采用免疫印迹法确诊，结核病的确诊依据：痰涂片检查、胸部X线检查、血沉、结核抗体以及结核DNA检查，并对所有患者资料进行总结和分析。结果：本组80例艾滋病合并结核病患者中，民工34例，个体15例，学生6例，工人7例，夜总会人员18例。传播途径：经血液传播36例，经性传播43例，母婴传播1例。患者主要表现持续发热、咳嗽、咳痰、皮疹等。结核分布一侧肺32例，双肺均有48例。结核类型：浸润型肺结核69例，其中有空洞6例，血型播散型肺结核11例。80例患者中痰涂片查到抗酸杆菌16例，阳性率20.0%，阴性64例(80.0%)，结核抗体阳性51例(63.75%)，血沉20～100 mm/h，平均56.6 mm/h，PPD强阳性42例，弱阳性28例，阴性10例。结核DNA均阳性，HIV检查结果：80例患者均经初筛实验阳性，并上报上级实验室均确诊，均为HIV-1阳性。CD4T淋巴细胞＜100/mm 319例，100～200/mm 339例，＞200/mm 322例。结核病灶明显吸收50例，死亡16例，病情恶化14例。结论：血沉在艾滋病合并结核病的诊断中具有重要意义，结核DNA检查是确诊结核感染的主要依据和HIV免疫印迹法检查是确诊HIV感染的主要方法，治疗原则是抗结核与抗病毒联合治疗。
目的：總結艾滋病閤併結覈病臨床特點，以降低漏診，提高臨床療效。方法：2010年2月-2014年7月收治艾滋病閤併結覈病患者80例，所有患者均進行ELISA法查HIV抗體鑑測，併經上級確診，實驗室採用免疫印跡法確診，結覈病的確診依據：痰塗片檢查、胸部X線檢查、血沉、結覈抗體以及結覈DNA檢查，併對所有患者資料進行總結和分析。結果：本組80例艾滋病閤併結覈病患者中，民工34例，箇體15例，學生6例，工人7例，夜總會人員18例。傳播途徑：經血液傳播36例，經性傳播43例，母嬰傳播1例。患者主要錶現持續髮熱、咳嗽、咳痰、皮疹等。結覈分佈一側肺32例，雙肺均有48例。結覈類型：浸潤型肺結覈69例，其中有空洞6例，血型播散型肺結覈11例。80例患者中痰塗片查到抗痠桿菌16例，暘性率20.0%，陰性64例(80.0%)，結覈抗體暘性51例(63.75%)，血沉20～100 mm/h，平均56.6 mm/h，PPD彊暘性42例，弱暘性28例，陰性10例。結覈DNA均暘性，HIV檢查結果：80例患者均經初篩實驗暘性，併上報上級實驗室均確診，均為HIV-1暘性。CD4T淋巴細胞＜100/mm 319例，100～200/mm 339例，＞200/mm 322例。結覈病竈明顯吸收50例，死亡16例，病情噁化14例。結論：血沉在艾滋病閤併結覈病的診斷中具有重要意義，結覈DNA檢查是確診結覈感染的主要依據和HIV免疫印跡法檢查是確診HIV感染的主要方法，治療原則是抗結覈與抗病毒聯閤治療。
목적：총결애자병합병결핵병림상특점，이강저루진，제고림상료효。방법：2010년2월-2014년7월수치애자병합병결핵병환자80례，소유환자균진행ELISA법사HIV항체감측，병경상급학진，실험실채용면역인적법학진，결핵병적학진의거：담도편검사、흉부X선검사、혈침、결핵항체이급결핵DNA검사，병대소유환자자료진행총결화분석。결과：본조80례애자병합병결핵병환자중，민공34례，개체15례，학생6례，공인7례，야총회인원18례。전파도경：경혈액전파36례，경성전파43례，모영전파1례。환자주요표현지속발열、해수、해담、피진등。결핵분포일측폐32례，쌍폐균유48례。결핵류형：침윤형폐결핵69례，기중유공동6례，혈형파산형폐결핵11례。80례환자중담도편사도항산간균16례，양성솔20.0%，음성64례(80.0%)，결핵항체양성51례(63.75%)，혈침20～100 mm/h，평균56.6 mm/h，PPD강양성42례，약양성28례，음성10례。결핵DNA균양성，HIV검사결과：80례환자균경초사실험양성，병상보상급실험실균학진，균위HIV-1양성。CD4T림파세포＜100/mm 319례，100～200/mm 339례，＞200/mm 322례。결핵병조명현흡수50례，사망16례，병정악화14례。결론：혈침재애자병합병결핵병적진단중구유중요의의，결핵DNA검사시학진결핵감염적주요의거화HIV면역인적법검사시학진HIV감염적주요방법，치료원칙시항결핵여항병독연합치료。
Objective:To summarize the clinical characteristics of AIDS complicated by tuberculosis,in order to reduce the misdiagnosis and improve the clinical efficacy.Methods:80 cases of AIDS complicated by tuberculosis were selected from February 2010 to July 2014.All patients were given ELASA method to check HIV antibody,and with the superior diagnosis,in the laboratory,the diagnosis method was western blot.Diagnosis of tuberculosis were based on:sputum smear examination,chest X-ray, blood sedimentation,tuberculosis and tuberculosis antibody DNA examination.All the data of patients were summarized and analyzed.Results:In 80 patients of AIDS complicated by tuberculosis,34 cases were migrant workers;15 cases were individual;6 cases were students;7 cases were workers;18 cases were club staff.Route of transmission were:blood spread in 36 cases,43 cases of sexual transmission,mother to child transmission of 1 case.The main performance were the persistent fever,cough,expectoration, rash,and so on.The distribution of pulmonary tuberculosis of 32 cases was in one side;48 cases were in double lungs.Tuberculosis types were:69 cases of infiltrative pulmonary tuberculosis,of which there were cavities in 6 cases,11 cases of hematogenous disseminated pulmonary tuberculosis.In 80 patients,16 cases of sputum smear for acid fast bacilli were positive,and positive rate was 20%;64 patients(80%) were negative;tuberculosis antibody was positive in 51 patients(63.75%).Erythrocyte sedimentation rate was 20 to 100mm/hour;average was 56.6mm/hour.PPD strong positive was in 42 cases;weakly positive was in 28 cases;10 cases were negative.Tuberculosis DNA were all positive.HIV findings:80 patients were positive underwent screening test,who reported to the superior diagnosis and laboratory diagnosis,and they were HIV-1 positive.CD4T lymphocyte was less than 100/mm in 319 cases;100/mm to 200/mm in 339 cases;322 cases were more than 200/mm.Tuberculosis was absorbed in 50 cases;16 cases were death;the condition of 14 cases was deteriorating.Conclusion:Erythrocyte sedimentation rate has important significance in the diagnosis of AIDS complicated by tuberculosis.Tuberculosis DNA examination is the main method for the diagnosis of tuberculosis infection.HIV blot examination is the main method for diagnosis of HIV infection.The principle of treatment is anti tuberculosis and antiviral combination therapy.
