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目的:分析和探讨艾滋病合并结核病患者的临床特征。方法:对84例艾滋病合并结核病患者的感染途径、临床特诊、辅助性检查以及临床诊断治疗进行回顾性分析。结果:84例患者中,男性居多,共有76例;平均年龄42.5岁,青壮年共有78例(92.9%,78/84);传播途径:血液传播77例(91.7%,77/84),性接触传播7例(8.3%,7/84);X线表现:中下肺野浸润41例(48.8%,41/84)、合并肺外结核21例(25.0%,21/84)、播散型肺结核9例(10.7%,9/84);临床表现:持续发热81例(96.4%,81/84)、咳嗽72例(85.7%,72/84)、胸痛21例(25.0%,21/84)、腹泻20例(23.8%,20/84)、浅表淋巴结肿大19例(22.6%,19/84)、呼吸困难18例(21.4%,18/84);经抗结核治疗后,1月内死亡20例,3个月死亡4例,3个月内死亡率为28.6%(24/84),好转47例(60.0%,47/84),治愈13例(15.5%,13/84)。结论:艾滋病合并结核病人的临床特征不一,同时病情复杂、肺外结核较多、X线表现不典型,并且具有较高的病死率。临床研究显示,抗病毒联合抗结核治疗具有一定的临床成效。
Objective: To analyze and discuss the clinical features of AIDS patients with tuberculosis. Methods: 84 cases of HIV-infected patients with tuberculosis infection, clinical special, supportive examination and clinical diagnosis and treatment were retrospectively analyzed. Results: Of the 84 patients, there were 76 males, with a mean age of 42.5 years. There were 78 cases (92.9%, 78/84) in young and middle-aged adults. Transmission was 77 cases (91.7%, 77/84) There were 7 cases (8.3%, 7/84) of contact and spread in X-ray; 41 cases (48.8%, 41/84) had pulmonary infiltration in the middle and lower lungs, 21 cases (25.0%, 21/84) 9 cases (10.7%, 9/84) of tuberculosis were found in the clinical stage. The clinical manifestations were persistent fever in 81 cases (96.4%, 81/84), cough in 72 cases (85.7%, 72/84), chest pain in 21 cases (25.0% (21 cases, 84 cases), 20 cases (23.8%, 20/84) of diarrhea, 19 cases of superficial lymph node enlargement (22.6%, 19/84) and 18 cases of dyspnea (21.4%, 18/84) There were 20 deaths in January and 4 deaths in 3 months. The mortality rate in 3 months was 28.6% (24/84), 47 cases (60.0%, 47/84) were cured and 13 cases (15.5% 84). Conclusion: The clinical features of HIV-infected TB patients are different. At the same time, the disease is complex, extra-pulmonary tuberculosis, X-ray is not typical, and has a high case fatality rate. Clinical studies have shown that antiviral combined with anti-TB therapy has some clinical efficacy.