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目的探讨艾滋病合并结核病患者的临床特点。方法回顾分析50例艾滋病合并结核病患者感染途径、临床表现、辅助检查及诊治情况。结果50例患者中青壮年43例占86.00%。HIV感染途径主要是血液接触传播46例(92.00%)和性接触传播3例(6.00%),母婴传播1例(2.00%)。临床表现:持续发热44例(88.00%)、咳嗽39例(78.00%)、胸痛16例(32.00%),呼吸困难11例(22.00%),腹泻9例(18.00%)、浅表淋巴结肿大12例(24.00%)等常见。X线表现:播散型肺结核5例(10.00%),中下肺野浸润10例(47.60%),合并肺外结核9例(18.00%),3个月内死亡率26.00%。经抗结核治疗后,大部分病人症状体征及胸片改善。结论艾滋病合并结核患者临床表现多样,X线表现不典型,肺外结核多,病情复杂,病死率高。抗结核与抗病毒联合治疗有一定效果。
Objective To investigate the clinical features of AIDS patients with tuberculosis. Methods A retrospective analysis of 50 cases of AIDS patients with tuberculosis infection, clinical manifestations, laboratory examinations and diagnosis and treatment. Results Among 50 patients, 43 cases were middle-aged and young, accounting for 86.00%. The main routes of HIV infection were blood contact transmission in 46 cases (92.00%), sexual contact transmission in 3 cases (6.00%) and mother-child transmission in 1 case (2.00%). Clinical manifestations: persistent fever in 44 cases (88.00%), cough in 39 cases (78.00%), 16 cases of chest pain (32.00%), dyspnea in 11 cases (22.00%), 9 cases of diarrhea (18.00%), superficial lymph nodes 12 cases (24.00%) and other common. X-ray findings included 5 cases of disseminated pulmonary tuberculosis (10.00%), 10 cases of middle and lower lung invasion (47.60%), 9 cases of extra-pulmonary tuberculosis (18.00%) and 26.00% within 3 months. After anti-TB treatment, most patients symptoms and signs and chest X-ray improved. Conclusion The clinical manifestations of AIDS patients with tuberculosis are diverse, X-ray findings are not typical, extra-pulmonary tuberculosis, complex disease, high mortality. Antituberculosis and anti-virus combination therapy has a certain effect.