艾滋病合并肺结核临床特点及其治疗(1)
[摘要] 目的 探究艾滋病合并肺結核临床特点及其治疗对策。方法 方便选取乌鲁木齐市友谊医院感染科2011年1月—2017年12月收治的210例艾滋病合并肺结核患者作为观察组，另外选取同期的70例单纯艾滋病患者作为对照组，对比分析艾滋病合并肺结核患者的临床特点和治疗方法。结果 观察组发热(90.48% vs 57.14%)、体质减轻(100.00% vs 28.57%)、咳嗽(74.29% vs 92.86%)、咳血(15.71% vs 48.57%)、贫血(62.38% vs 37.14%)的发生率与对照组差异有统计学意义(χ2=39.768 1、182.608 7、10.887 3、31.137 3、13.576 4，P<0.05)；患者进行影像学检查，观察组患者均有结核影像学表现，病变部位弥漫性累及双肺、双肺上叶尖后段和下叶背段、肺基底部，两组患者在合并空洞、斑块状或大片阴影、结核性淋巴结转移和肿大、结核性胸膜炎、合并胸腔积液上差异有统计学意义(χ2=13.612 3、7.200 3、 16.773 1、18.403 5、21.741 2，P<0.05)；实验室检测上，观察组阳性率显著低于对照组(χ2=22.435 9、155.035 6，P<0.05)。临床上，按照艾滋病合并肺结核患者的病情，给予抗结核和抗病毒治疗，治疗难度较大。 结论 艾滋病合并肺结核患者的临床特点多样，无典型性，因此需要医师综合考虑临床特点、实验室指标等，并做好早期筛查工作，依据患者的实际病情制定针对性的治疗措施，以降低患者的死亡率，提高患者的生存质量。
[关键词] 艾滋病；肺结核；临床特点；治疗
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)04(c)-0031-03
Clinical Characteristics and Treatment of AIDS Combined with Pulmonary Tuberculosis
CAO Shi-min， HU Li-hua
Department of Infection， Urumqi Friendship Hospital， Urumqi， Xinjiang， 830049 China
[Abstract] Objective To explore the clinical characteristics and treatment strategies of AIDS combined with pulmonary tuberculosis. Methods From January 2011 to December 2017， 210 cases of patients with AIDS combined with pulmonary tuberculosis were conveniently selected as the observation group， besides， 70 cases of simple AIDS patients were selected as control group， the clinical characteristics and treatment method were compared between the two groups. Results There were obvious differences in the fever， physique reduction， cough， hemoptysis and anemia between the observation group and the control group， [(90.48% vs 57.14%)，(100.00% vs 28.57%)，(74.29% vs 92.86%)，(15.71% vs 48.57%)，(62.38% vs 37.14%)](χ2=39.768 1， 182.608 7， 10.887 3， 31.137 3， 13.576 4， P<0.05) ， and there were obvious differences in the cavity， plaque or large shadow， tuberculous lymph node metastasis and enlargement， tuberculous pleuritis and pleural effusion between the two groups，(χ2=13.612 3， 7.200 3， 16.773 1， 18.403 5， 21.741 2， P<0.05) ， and the positive rate in the observation group was obviously lower than that in the control group (χ2=22.435 9， 155.035 6， P<0.05) ， and the patients should be given the antituberculosis and anti-viral therapy according to the diseases and the treatment difficulty was high. Conclusion The clinical manifestations of patients with pulmonary tuberculosis in AIDS patients are diversity， but they are not typical， therefore， the physicians need to comprehensively consider the clinical features and laboratory indexes， as well as do well in early screening work， make treatment measures according to the patient's practical condition， thus reducing the mortality of patients， and improving the quality of life of patients., 百拇医药(曹世敏 胡丽华)
[关键词] 艾滋病；肺结核；临床特点；治疗
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)04(c)-0031-03
Clinical Characteristics and Treatment of AIDS Combined with Pulmonary Tuberculosis
CAO Shi-min， HU Li-hua
Department of Infection， Urumqi Friendship Hospital， Urumqi， Xinjiang， 830049 China
[Abstract] Objective To explore the clinical characteristics and treatment strategies of AIDS combined with pulmonary tuberculosis. Methods From January 2011 to December 2017， 210 cases of patients with AIDS combined with pulmonary tuberculosis were conveniently selected as the observation group， besides， 70 cases of simple AIDS patients were selected as control group， the clinical characteristics and treatment method were compared between the two groups. Results There were obvious differences in the fever， physique reduction， cough， hemoptysis and anemia between the observation group and the control group， [(90.48% vs 57.14%)，(100.00% vs 28.57%)，(74.29% vs 92.86%)，(15.71% vs 48.57%)，(62.38% vs 37.14%)](χ2=39.768 1， 182.608 7， 10.887 3， 31.137 3， 13.576 4， P<0.05) ， and there were obvious differences in the cavity， plaque or large shadow， tuberculous lymph node metastasis and enlargement， tuberculous pleuritis and pleural effusion between the two groups，(χ2=13.612 3， 7.200 3， 16.773 1， 18.403 5， 21.741 2， P<0.05) ， and the positive rate in the observation group was obviously lower than that in the control group (χ2=22.435 9， 155.035 6， P<0.05) ， and the patients should be given the antituberculosis and anti-viral therapy according to the diseases and the treatment difficulty was high. Conclusion The clinical manifestations of patients with pulmonary tuberculosis in AIDS patients are diversity， but they are not typical， therefore， the physicians need to comprehensively consider the clinical features and laboratory indexes， as well as do well in early screening work， make treatment measures according to the patient's practical condition， thus reducing the mortality of patients， and improving the quality of life of patients., 百拇医药(曹世敏 胡丽华)
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