获得性免疫缺陷综合征合并肺结核359例临床流行病学研究

发布时间：2018-04-09 13:53

  本文选题：获得性免疫缺陷综合征　切入点：肺结核　出处：《中国感染与化疗杂志》2017年03期

【摘要】：目的分析获得性免疫缺陷综合征(AIDS)合并肺结核患者的流行病学及临床特征。方法采用回顾性研究方法,收集2011年1月-2015年12月在上海市公共卫生临床中心诊断为AIDS合并肺结核患者的病历资料,并通过门诊随访和电话随访,了解患者的预后情况。运用SPSS 22.0软件,对其特征进行描述性分析。结果 359例AIDS合并肺结核患者中男325例,女34例,30~44岁所占比例最大,42.6%患者出现发现延误;临床症状以发热、咳嗽、体重下降较多见,咯血少见,多数研究对象两肺受累,病变范围≥3个肺野,空洞少见;T-SPOT阳性率偏低,50.7%患者首次检查CD4~+T淋巴细胞计数≤50/μL;69例患者痰结核菌药敏结果显示,43.5%出现耐药;已知抗病毒状态中的患者93.2%已经进行了抗病毒治疗;282例合并肺外结核,合并症及机会性感染以中枢神经系统感染、梅毒、乙型或丙型病毒性肝炎、肺部感染、药物性肝损等为主;333例已知预后情况的患者中53例死亡,其中79.2%在6个月内死亡。结论 AIDS合并肺结核患者年轻患者比例大,影像学表现不典型,T-SPOT阳性率偏低,首次CD4~+T淋巴细胞计数较低,多数患者合并肺外结核,合并症和机会性感染较多,患者多在6个月内死亡。
[Abstract]:Objective to analyze the epidemiological and clinical features of acquired immunodeficiency syndrome (AIDS) complicated with pulmonary tuberculosis.Methods A retrospective study was conducted to collect the medical records of AIDS patients with pulmonary tuberculosis diagnosed in Shanghai Public Health Clinical Center from January 2011 to December 2015. The prognosis of the patients was analyzed by out-patient follow-up and telephone follow-up.SPSS 22. 0 software is used to analyze its characteristics.Results there were 325 males and 34 females aged 30 to 44 years old in AIDS with pulmonary tuberculosis. The clinical symptoms were fever, cough, weight loss, hemoptysis and hemoptysis.The extent of lesion was more than 3 lung fields, and the positive rate of T-spot was low in 50.7% of the patients. In 69 patients with CD4 ~ T lymphocyte count 鈮，

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