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目的 :调查艾滋病病毒 (HIV) /艾滋病 (AIDS)患者结核菌素 (PPD)试验反应状况及与免疫系统受损程度的联系 ,并探讨其预防和治疗结核病的意义。方法 :采用前瞻性病例对照研究方法 ,对 40例HIV /AIDS患者和 2 0 2例健康者做结核菌素试验 ,并对HIV/AIDS患者做CD4、CD8细胞计数测定 ,对HIV/AIDS患者分组服药 ,观察胸部病变及结核发生情况。结果 :HIV/AIDS患者与健康者PPD阳性率分别为 12 .5 %、2 8.2 % ,差异有显著性意义 ( χ2 =4.3 3P <0 .0 5 )。当CD4细胞计数下降时 ,PPD反应减弱。CD4<2 0 0个 /mm3 时PPD均无反应 ( 0× 0 )。病例服药组经化学药物预防治疗后其肺部病变异常率及结核的发病率小于病例对照组。结论 :HIV/AIDS患者PPD阳性率显著低于健康者。CD4细胞数下降可能是艾滋病并发结核的主要原因。对HIV/AIDS患者使用化学药物预防和治疗结核有效 ,同时为制定相关政策提供了依据。
Objective: To investigate the reaction status of tuberculin (PPD) test in patients with HIV / AIDS and its relationship with the damage of the immune system, and to explore its significance in the prevention and treatment of tuberculosis. Methods: A prospective case-control study was conducted on tuberculin in 40 HIV / AIDS patients and 202 healthy individuals. CD4 and CD8 cell counts were determined in HIV / AIDS patients and HIV / AIDS patients were divided into groups Take medicine, observe the chest lesions and tuberculosis. Results: The positive rates of PPD in HIV / AIDS patients and healthy controls were 12.5% and 8.22% respectively, with significant difference (χ2 = 4.3 3P <0.05). When the CD4 cell count decreased, the PPD response was weakened. There was no response to PPD at CD4 <200 cells / mm3 (0 × 0). The incidence of pulmonary abnormalities and tuberculosis in the medication group was less than that of the case-control group after chemical and drug preventive treatment. Conclusion: The positive rate of PPD in HIV / AIDS patients is significantly lower than that in healthy people. The decline of CD4 cell count may be the main reason for AIDS complicated by tuberculosis. The use of chemical drugs to prevent and treat TB in HIV / AIDS patients is effective and provides the basis for the formulation of relevant policies.