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目的分析艾滋病病毒(HIV)感染对结核病发病和抗结核治疗效果带来的影响及其相关因素。方法从结核病信息管理系统中导出3省9个县2007年9月1日—2009年8月31日12 516例结核病患者患病和治疗的相关信息,从艾滋病防治机构收集HIV阳性患者的艾滋病相关信息,比较HIV阳性和阴性患者的患病特征和抗结核治疗效果。结果与12 069例HIV阴性患者比较,447例HIV阳性患者痰涂片阴性比例较高(68.5%vs36.4%,χ2=188.46,P<0.01)、肺部出现空洞的比例相对较低(3.8%vs 11.0%,χ2=23.18,P<0.01)、治疗成功率较低(89.0%vs 96.1%,χ2=54.86,P<0.01)、非结核死亡率较高(8.3%vs 0.7%,χ2=261.48,P<0.01);诊断肺结核时CD4<200个/μL和未接受抗病毒治疗的HIV阳性患者死亡风险较高。结论艾滋病的流行给结核病的诊断和治疗效果带来了负面影响,及早发现HIV阳性的结核病患者并给予抗结核和抗病毒治疗,有助于降低患者的病死率。
Objective To analyze the impact of HIV infection on the incidence of tuberculosis and the effect of anti-TB treatment and its related factors. Methods Nine counties and nine counties in three provinces were derived from the TB information management system. From September 1, 2007 to August 31, 2009, information on the prevalence and treatment of 12 516 tuberculosis patients was collected from HIV / AIDS prevention and control institutions Information to compare the prevalence of anti-TB treatment and HIV-positive and -negative patients. Results Compared with 12 069 HIV-negative patients, 447 HIV-positive patients had a higher proportion of negative sputum smears (68.5% vs36.4%, χ2 = 188.46, P <0.01) % vs 11.0%, χ2 = 23.18, P <0.01). The success rate of treatment was lower (89.0% vs 96.1%, χ2 = 54.86, P <0.01) 261.48, P <0.01). At diagnosis of tuberculosis, the CD4 death rate was higher in CD4 + <200 cells / μL and non-HIV-positive HIV-positive patients. Conclusion The prevalence of AIDS has a negative impact on the diagnosis and treatment of tuberculosis. Early detection of HIV-positive TB patients and treatment with anti-TB and anti-virus drugs will help to reduce the case fatality rate.