论文部分内容阅读
目的探讨艾滋病合并肺结核的临床特点及治疗方法。方法总结123例艾滋病合并肺结核患者的临床资料。结果123例患者均为青壮年人。平均年龄31岁,无业67例(54%)。感染途径:静脉注射毒品92例(75%),性乱史18例(15%),不详13例(11%)。临床特点:发113热例(82%),消瘦112例(91%),全身酸痛,乏力,纳差121例(98%),咳嗽118例(96%),咳痰107例(87%),腹泻38例(31%),浅表淋巴结肿大37例(30%)。X线特点:双肺与中下肺叶浸润病灶为主,肺门纵膈淋巴结肿大,急性血播,薄壁空洞型肺结核并支气管播散病灶与胸膜炎病人多见。合并丙型肝炎34例(28%),乙型肝炎9例(7%),梅毒4例(3%),带状疱疹7例(6%)。经抗结核治疗后患者症状、体征、胸片病灶明显好转,部分痰涂片转阴。结论艾滋病合并肺结核常发病急,症状重,原有结核病特点不典型。临床医师应重视艾滋病合并肺结核的临床特点,X线特点。抗结核治疗对本病较为安全。对肺结核,HCV感染等,带状疱疹病人应常规监测HIV抗体。
Objective To investigate the clinical features and treatment of AIDS complicated with pulmonary tuberculosis. Methods The clinical data of 123 patients with AIDS complicated with pulmonary tuberculosis were summarized. Results 123 patients were young adults. The average age was 31 and 67 were unemployed (54%). Infection routes: 92 cases (75%) of intravenous drug abuse, 18 cases of sexual disorder (15%), 13 cases (11%) unknown. Clinical features: 113 cases of fever (82%), 112 cases of emaciation (91%), body aches, fatigue, anorexia in 121 cases (98%), cough in 118 cases (96% , 38 cases of diarrhea (31%), 37 cases of superficial lymph nodes (30%). X-ray features: infiltration of lung and lung lesions in the main lung-based, hilar mediastinal lymph nodes, acute blood transfusion, thin-walled hollow tuberculosis and bronchial lesions and pleurisy more common. 34 (28%) had hepatitis C, 9 (7%) had hepatitis B, 4 (3%) had syphilis, and 7 (6%) had shingles. After anti-TB treatment of patients with symptoms, signs, chest X-ray lesions were significantly improved, some sputum smear negative. Conclusions HIV / AIDS is often associated with acute and severe symptoms of tuberculosis. The original features of tuberculosis are not typical. Clinicians should pay attention to the clinical features of AIDS complicated with pulmonary tuberculosis, X-ray features. Anti-TB treatment of the disease is more secure. For tuberculosis, HCV infection, etc., patients with herpes zoster should be routinely monitored for HIV antibodies.