To discuss and analyze the clinical character of pulmonary tuberculosis as a complication of immune reconstitution syndrome ( IRS ) developed after highly active antiretroviral therapy ( HAART ) in AIDS patients so as to improve the level of diagnosis and treatment. Methods The clinical data of 42 cases of pulmonary tuberculosis as a complication of IRS of AIDS. Results ( 1 ) The IRS patients with pulmonary tuberculosis complication of IRS had few symptoms in respiratory tract ( 11/42, accounting for 26. 2% ), and few toxic symptoms of tuberculosis ( 12/42, accounting for 28. 6% ). ( 2 ) The pulmonary nodules ( 17/42, accounting for 40. 5% ) and mediastinal lymphadenopathy ( 15/42, accounting for 35. 7% ) took the major proportion; the rate of cavity development was lower ( 8/42, accounting for 19.0%), and the positivity rate of sputum was only 19. 0% ( 8/42 ). Conclusion The clinical manifestation of pulmonary tuberculosis as a complication in IRS of AIDS is not typical so that it is difficult for diagnosis, however empirical therapy is helpful.%目的 探讨分析艾滋病(AIDS)高效抗逆转录病毒治疗(HAART)后发生免疫重建综合征(IRS)并发肺结核的临床特点,提高诊治水平.方法 对42例HAART后发生IRS并发肺结核患者的临床资料进行分析.结果 (1)艾滋病HAART后发生IRS并发肺结核病例呼吸道症状较少(占26.2%,11/42),结核中毒症状也少见(占28.6%,12/42).(2)肺部以结节性病变(占40.5%,17/42)及纵隔淋巴结肿大(占35.7%,15/42)为主,空洞性病灶发生率低(占19.0%,8/42),痰菌阳性率仅为19.0%(8/42).结论 艾滋病HAART后发生IRS并发肺结核临床表现不典型,诊断困难,经验性治疗有助于诊断.
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