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目的探讨HIV感染与AIDS患者CD4+T淋巴细胞计数与肺结核主要临床症状、体征的相关性。方法选择2010年7月至2012年6月期间在广西CDC、广西龙潭医院、南宁市第四人民医院就诊登记的HIV感染与AIDS患者733例,采用液体培养和改良中性罗氏培养方法对患者痰标本进行结核分枝杆菌培养,采用流式细胞仪检测法对CD4+T细胞进行检测,分析CD4+T淋巴细胞计数与肺结核相关临床症状、体征的关系。结果HIV感染与AIDS患者结核分枝杆菌痰培养阳性率为16.1%(118/733)。CD4+T淋巴细胞计数分级为1级的痰培养阳性率为12.3%(9/73),2级为10.3%(6/58),3级为17.0%(15/88),4级为17.1%(88/514),不同CD4+T淋巴细胞计数级别的痰培养阳性率的差异无统计学意义(χ2趋势性=2.004,P=0.157);不同级别CD4+T淋巴细胞计数与结核分枝杆菌培养阳性率之间具有相关性(r=-0.048,P=0.035)。CD4+T淋巴细胞计数与是否有咳嗽、咯痰>2周症状有关,有咳嗽、咯痰>2周症状的患者CD4+T淋巴细胞计数(1.54±0.65)lg低于无该症状的患者(1.68±0.70)lg(t=-2.621,P=0.009)。结论HIV感染与AIDS患者CD4+T淋巴细胞计数级别与结核分枝杆菌痰培养结果具有相关性,临床上对于咳嗽、咯痰>2周的HIV感染与AIDS患者应予以重视,警惕合并肺结核的可能。
Objective To investigate the correlation between CD4 + T lymphocyte count and major clinical symptoms and signs of pulmonary tuberculosis in HIV infected and AIDS patients. Methods A total of 733 cases of HIV-infected and AIDS-infected patients were enrolled in Guangxi CDC, Guangxi Longtan Hospital and Nanning No. 4 People’s Hospital from July 2010 to June 2012. The patients were treated with liquid culture and modified neutral Roche culture The specimens were cultured in Mycobacterium tuberculosis. The detection of CD4 + T cells by flow cytometry was used to analyze the relationship between CD4 + T lymphocyte count and clinical symptoms and signs related to pulmonary tuberculosis. Results The positive rate of sputum culture of Mycobacterium tuberculosis in HIV-infected and AIDS patients was 16.1% (118/733). The sputum culture positive rate of CD4 + T lymphocyte count grade 1 was 12.3% (9/73), grade 2 was 10.3% (6/58), grade 3 was 17.0% (15/88), grade 4 was 17.1 % (88/514). There was no significant difference in sputum culture positive rates between different CD4 + T lymphocyte count levels (χ2 trend = 2.004, P = 0.157). Different CD4 + T lymphocyte counts were significantly different from tuberculosis branches There was a correlation between the positive rate of bacillus culture (r = -0.048, P = 0.035). CD4 + T lymphocyte count CD4 + T lymphocyte count (1.54 ± 0.65) lg in patients with symptoms of cough and expectoration> 2 weeks was lower than those without symptoms of cough and expectoration> 2 weeks 1.68 ± 0.70) lg (t = -2.621, P = 0.009). Conclusion HIV infection and CD4 + T lymphocyte count in AIDS patients are correlated with sputum culture results of Mycobacterium tuberculosis. Clinically, HIV infection with cough and expectoration> 2 weeks should be paid more attention to patients with AIDS and alert to possible pulmonary tuberculosis .