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目的 调查艾滋病病毒 (HIV) /艾滋病 (AIDS)患者结核菌素纯蛋白衍化物 (PPD)试验反应状况及与免疫系统受损程度的联系 ,并探讨其在HIV/AIDS患者中结核病 (TB)预防和治疗研究的意义。方法 采用前瞻性病例对照研究方法 ,对 2 0 2例健康者及 5 5例经蛋白印迹试验 (WB)确证的HIV感染者和AIDS病人做PPD试验 ,CD4、CD8淋巴细胞计数及分组服药 ,对照观察胸部病变情况。结果 HIV/AIDS患者PPD试验阳性率为 10 0 % ,健康者PPD试验阳性率 2 8 2 % ,差异有非常显著的统计学意义 (χ2 =7 17,P <0 0 1)。 13例CD4细胞计数 <2 0 0 /mm3 的HIV/AIDS病例 ,PPD试验均无反应 (0× 0mm)。当CD4细胞计数升高时 ,其PPD试验反应增强。病例服药组经化学药物预防治疗后 ,其肺部病变异常率为 30 8% ,低于病例对照组的异常率 4 1 7%。结论 HIV/AIDS患者PPD试验阳性率非常显著地低于健康人。对HIV/AIDS患者使用化学药物预防和治疗TB是有效的 ,这为制定相关政策提供了依据
Objective To investigate the reaction status of tuberculin pure protein derivative (PPD) test in patients with HIV / AIDS and their relationship with the damage of the immune system, and to explore the preventive measures against tuberculosis (TB) in HIV / AIDS patients And the significance of treatment research. Methods A prospective case-control study was conducted. The PPD test, CD4 and CD8 lymphocyte count and grouping of drugs were performed on 202 healthy controls and 55 HIV-infected and AIDS-infected patients confirmed by Western blotting (WB) Observation of chest lesions. Results The positive rate of PPD test was 100% in HIV / AIDS patients and 28.2% in healthy subjects. The difference was statistically significant (χ2 = 7 17, P <0.01). Thirteen cases of HIV / AIDS with a CD4 count <200 / mm3 did not respond to the PPD test (0 × 0 mm). When the CD4 cell count increased, its PPD test response increased. After taking the chemical and drug preventive treatment, the abnormal rate of pulmonary disease in the medication group was 30.8%, which was lower than that of the case-control group (41.7%). Conclusion The positive rate of PPD in HIV / AIDS patients is significantly lower than that in healthy people. The use of chemical drugs to prevent and treat TB in HIV / AIDS patients is effective, which provides the basis for the formulation of relevant policies