CD+4T淋巴细胞计数在艾滋病合并肺结核诊断中的应用价值

摘要

目的 探讨CD+4T淋巴细胞计数在艾滋病合并肺结核实验室诊断中的应用价值.方法 选择艾滋病合并肺结核患者43例为研究对象,其中14例患者为典型肺结核(X线胸片或者胸部CT具有显著特征),29例为不典型肺结核(X线胸片或者胸部CT无明显特征).并对43例患者进行CD+4T淋巴细胞计数检查、痰涂片结核抗酸杆菌试验及γ干扰素释放试验(T-SPOT.TB)检测,比较各种方法的检测结果.结果 典型肺结核患者的CD+4T淋巴细胞计数为(151.26±59.47)个/μL,不典型肺结核CD+4T淋巴细胞计数为(69.11±19.65)个/μL,两者差异有统计学意义(t=5.124,P<0.05);且随着CD+4T淋巴细胞的减少,艾滋病患者多表现为不典型肺结核.CD+4T淋巴细胞计数、T-SPOT.TB、痰涂片结核抗酸杆菌试验检测的阳性率分别为86.05%、16.28%、51.16%,三种方法联合检测的阳性率(90.70%)显著高于各项单独检测,差异均有统计学意义(x2=5.123、6.023、7.125,均P<0.05).结论 CD+4T淋巴细胞计数在艾滋病合并肺结核的实验室诊断中具有十分重要的借鉴价值,值得在临床广泛开展.%Objective To explore the value of CD+4T lymphocyte count in laboratory diagnosis of AIDS complicated with pulmonary tuberculosis.Methods Forty-three patients with acute tuberculosis were selected as the subjects.Among them,14 patients had typical tuberculosis(X-ray or chest CT),29 cases were atypical tuberculosis(X-ray or chest CT).43 patients were examined by CD+4T lymphocyte count,sputum smear tuberculosis acid-fast bacilli test and T-SPOT.TB(interferon-γ release test),and the results of various methods were compared.Results The The number of CD+4T lymphocytes in patients with typical pulmonary tuberculosis was (151.26±59.47)/μL,and that in atypical pulmonary tuberculosis was (69.11±19.65)/μL,the difference was statistically significant(t=5.124,P<0.05);and with the reduction of CD+4T lymphocytes,AIDS patients showed more atypical pulmonary tuberculosis.The positive detection rates of CD+4T lymphocyte count,T-SPOT.TB and sputum smear were 86.05%,16.28% and 51.16% respectively.The positive rate of combined detection of three methods(90.70%) was significantly higher,the differences were statistically significant(x2=5.123,6.023,7.125,all P<0.05).Conclusion CD+4T lymphocyte count is of great value in the laboratory diagnosis of AIDS complicated with tuberculosis,and it is worthy to be widely carried out in clinical practice.