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目的了解中国内地 HIV/AIDS 合并结核感染的概况,总结分析 HIV/AIDS 合并结核感染者的临床表现、实验室检查以及治疗转归情况。方法采用统一调查表格收集中国内地不同省份的9家医院 HIV/AIDS 合并结核感染者的各项指标并进行统计分析。结果 HIV/AIDS 合并结核感染者241例,以男性(75.9%)青壮年为主。新疆和云南以静脉注射毒品感染为主,其他省市以输血及血制品(上海、河南、山西闻喜县)和性传播(福州、上海、深圳、云南德宏傣族景颇族自治州)为多。单纯肺结核占59.3%,肺外结核21.2%,肺内合并肺外结核19.5%。痰结核培养阳性率2.9%,痰抗酸染色阳性率9.5%,胸水或脑脊液标本抗酸染色阳性率10.8%,PPD 大多显示阴性或弱阳性。CD_4~+T 淋巴细胞计数<200个/ul 的有76.8%,<100个/ul 的有58.5%。80.5%的患者接受抗结核治疗,69.7%的患者接受高效联合抗反转录病毒治疗(HAART)。存活203例(84.2%),死亡38例(15.8%)。结论 9家医院的241例 HIV/AIDS 合并结核感染者以肺结核为多,临床表现多样,CD_4~+T 淋巴细胞计数低下,免疫功能差。结核相关的实验室检查指标阳性率低,对诊断帮助不大。虽然大多数患者接受 HAART 和(或)抗结核治疗,但病死率达15.8%。
Objective To understand the prevalence of HIV / AIDS-associated tuberculosis (TB) infection in Mainland China and analyze the clinical manifestations, laboratory tests and treatment outcome of HIV / AIDS-infected TB patients. Methods The questionnaire was used to collect and analyze the indicators of HIV / AIDS-infected patients with tuberculosis in 9 hospitals in different provinces in mainland China. Results There were 241 cases of HIV / AIDS complicated with tuberculosis infection, mainly male (75.9%) young adults. In Xinjiang and Yunnan, intravenous drug-induced infections are the mainstay. Other provinces and municipalities mainly transfusion and blood products (Shanghai, Henan and Shanxi Wenxi) and sexually transmitted (Fuzhou, Shanghai, Shenzhen and Yunnan Dehong Dai-Jingpo Autonomous Prefecture). Simple tuberculosis accounted for 59.3%, extrapulmonary tuberculosis 21.2%, pulmonary tuberculosis with pulmonary tuberculosis 19.5%. The positive rate of sputum tuberculosis culture was 2.9%, the positive rate of sputum acid-fast staining was 9.5%, the positive rate of acid-fast staining of pleural effusion or cerebrospinal fluid was 10.8%, most of them showed negative or weak positive. 76.8% of CD_4 ~ + T lymphocyte counts <200 / ul and 58.5% of <100 / ul. 80.5% received anti-TB treatment and 69.7% received HAART. Survival of 203 patients (84.2%), 38 patients died (15.8%). Conclusions 241 cases of HIV / AIDS co-infected with tuberculosis in 9 hospitals are characterized by tuberculosis. Their clinical manifestations are diverse, their CD_4 ~ + T lymphocyte count is low, and immune function is poor. TB-related laboratory tests positive rate is low, little help in the diagnosis. Although most patients underwent HAART and / or anti-TB treatment, the case fatality rate was 15.8%.