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目的分析艾滋病合并肺外结核组织的病理表现及与脓毒症的关系。方法回顾性分析45例经病原学及临床诊断为艾滋病合并肺外结核患者手术切取标本的病理表现和临床实验室资料。结果 45例艾滋病合并肺外结核患者的组织病理表现,有上皮样肉芽肿组术前脓毒症发病率34.4%,明显低于无上皮样肉芽肿组的脓毒症发病率69.2%(P<0.05),而在其他临床实验室特征方面无明显差异,上皮样肉芽肿与术前脓毒症二者之间具有负相关性(r=-0.318,P<0.05)。结论艾滋病合并肺外结核组织病理表现与术前脓毒症发病率有关,其中上皮样肉芽肿能较好地反映艾滋病合并肺外结核术前脓毒症的发病率情况,对于术前脓毒症的诊断也同样具有重要的参考价值。特别是当结核菌涂片或培养结果为阴性时,对及早地进行抗结核性脓毒症治疗以降低脓毒症的死亡率方面具有更加积极的意义。
Objective To analyze the pathological manifestations of AIDS complicated with extrapulmonary tuberculosis and its relationship with sepsis. Methods The pathological findings and clinical laboratory data of 45 cases with pathologically and clinically diagnosed AIDS complicated with extrapulmonary tuberculosis were retrospectively analyzed. Results The histopathological findings of 45 patients with AIDS complicated with extrapulmonary tuberculosis showed that the incidence of preoperative sepsis was 34.4% in epithelioid granuloma group and significantly lower than that in seroepitheliomatous granuloma group (69.2%, P < 0.05), while there was no significant difference in other clinical laboratory features. There was a negative correlation between epithelioid granuloma and preoperative sepsis (r = -0.318, P <0.05). Conclusions The pathological manifestations of AIDS complicated with extrapulmonary tuberculosis are related to the incidence of preoperative sepsis, of which, epithelial-like granuloma can better reflect the pre-sepsis incidence of AIDS complicated with extrapulmonary tuberculosis. Preoperative sepsis The diagnosis also has important reference value. Especially when TB smear or culture results are negative, it is more positive for the early anti-tuberculosis sepsis treatment to reduce the mortality rate of sepsis.