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目的比较HIV/TB双重感染患者结核病的各检查手段的临床意义。方法回顾性分析2008年1月-2016年10月在天津市海河医院住院诊疗的94例HIV/TB患者的资料,并与无合并HIV的结核患者进行对比,分析PPD、TTSPOT.TB、血沉、结核抗体、痰结核菌等各种检查手段的阳性率。结果 HIV/TB双重感染患者的男:女=81:13,平均年龄为(44.1±14.0)岁,临床症状不典型,继发性肺结核的比例最高,占62.8%(59/94),其次淋巴结结核占20.2%(19/94),血型播散型肺结核占9.6%(9/94),肠结核占14.9%(14/94),结核性胸膜炎占23.4%(22/94),总共肺外结核患者占59.6%(56/94);PPD、结核抗体、痰抗酸染色、痰液培养阳性率低,血沉、T-SPOT.TB阳性率高,但是仅HIV/TB双重感染的结核抗体、血沉和无合并HIV的结核患者检查阳性率差异有统计学意义(P<0.05)。结论 HIV/TB双感染患者的结核病症状不典型,但是各种检查的联合诊断对于HIV感染患者的早期诊断活动性结核病更有意义,使HIV/TB双重感染患者得到尽早的诊疗。
Objective To compare the clinical significance of tuberculosis in patients with HIV / TB double infection. Methods The data of 94 HIV / TB patients hospitalized in Haihe Hospital of Tianjin from January 2008 to October 2016 were retrospectively analyzed. The data of PPD, TTSPOT.TB, ESR, Tuberculosis antibodies, sputum and other means of detection of TB test positive rate. Results The average HIV prevalence of HIV / TB patients was 81: 13 (44.1 ± 14.0) years old with atypical clinical manifestations and 62.8% (59/94) cases of secondary pulmonary tuberculosis. The second was lymph nodes Tuberculosis accounted for 20.2% (19/94), blood disseminated tuberculosis accounted for 9.6% (9/94), intestinal tuberculosis accounted for 14.9% (14/94), tuberculous pleurisy accounted for 23.4% (22/94), the total extrapulmonary Tuberculosis patients accounted for 59.6% (56/94); PPD, tuberculosis antibody, sputum acid-fast staining, sputum culture positive rate was low, erythrocyte sedimentation rate, T-SPOT.TB positive rate, but only HIV / TB double infection of tuberculosis antibody, The positive rates of ESR and tuberculosis without HIV infection were significantly different (P <0.05). Conclusions Tuberculosis symptoms in patients with HIV / TB double infection are not typical, but the combined diagnosis of various tests is more meaningful for the early diagnosis of active tuberculosis in HIV-infected patients, so that the patients with HIV / TB double infection can be diagnosed as soon as possible.