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目的探讨艾滋病合并结核病患者的临床特点。方法回顾分析50例艾滋病合并结核病患者感染途径、临床表现、辅助检查及诊治情况。结果 50例患者中青壮年43例占86.0%。HIV感染途径主要是血液接触传播46例(92.0%)和性接触传播3例(6.0%),母婴传播1例(2.0%)。临床表现:持续发热44例(88.0%)、咳嗽39例(78.0%)、胸痛16例(32.0%),呼吸困难11例(22.0%),腹泻9例(18.0%)、浅表淋巴结肿大12例(24.0%)等常见。X线表现:播散型肺结核5例(10.0%),中下肺野浸润10例(47.6%),合并肺外结核9例(18.0%),3个月内死亡率26.0%。经抗结核治疗后,大部分病人症状体征及胸片改善。结论艾滋病合并结核病患者临床表现多样,X线表现不典型,肺外结核多,病情复杂,病死率高。抗结核与抗病毒联合治疗有一定效果。
Objective To investigate the clinical features of AIDS patients with tuberculosis. Methods A retrospective analysis of 50 cases of AIDS patients with tuberculosis infection, clinical manifestations, laboratory examinations and diagnosis and treatment. Results of 50 cases of young and middle-aged 43 cases accounted for 86.0%. HIV infection was mainly caused by 46 cases (92.0%) of blood contact and 3 cases (6.0%) of sexual contact and 1 case (2.0%) of mother-to-child transmission. Clinical manifestations: persistent fever in 44 (88.0%), cough in 39 (78.0%), chest pain in 16 (32.0%), dyspnea in 11 (22.0%), diarrhea in 9 (18.0%), superficial lymph nodes 12 cases (24.0%) and other common. X-ray showed 5 cases (10.0%) of disseminated pulmonary tuberculosis, 10 cases (47.6%) of middle and lower lung invasion, 9 cases (18.0%) with extrapulmonary tuberculosis and 26.0% within 3 months. After anti-TB treatment, most patients symptoms and signs and chest X-ray improved. Conclusion The clinical manifestations of AIDS patients with tuberculosis are diverse, X-ray findings are not typical, extra-pulmonary tuberculosis, the disease is complex, high mortality. Antituberculosis and anti-virus combination therapy has a certain effect.