目的 探讨HIV/AIDS合并肺结核与单纯肺结核患者临床特征的区别及疗效分析.方法 收集2011年1月至2015年12月诊治及随访的肺结核患者189例,根据CD4+T淋巴细胞数是否＞ 200个/μL将HIV/AIDS合并肺结核患者(102例)分为A组(CD4+T≤200个/μL)和B组(CD4+T＞200个/μL),单纯肺结核87例为C组.分别对患者临床症状、实验室检查、胸部X线表现及疗效等进行分析.结果 与B、C组相比,A组临床表现以全身症状为主,实验室检查阳性率均较B组、C组低,全胸片多表现为弥漫性分布,多肺野常见,纤维条索、空洞影较少.B组多肺野浸润较C组常见,PPD阳性率低于C组,均P＜0.017.相同治疗方案A组总有效率低于B、C组,治疗延长3个月与B、C组相当.结论 对疑似HIV/AIDS合并肺结核患者行CD4+T淋巴细胞检测对该类患者早诊断治疗与隔离有重要意义.%Objective To analyze the therapeutic effects and investigate the differences in clinical characteristics betweenpatients with tuberculosis complicated by HIV/AIDS and those withtuberculosis alone.Methods The data on 189 patients with pulmonary tuberculosis who had received treatment and follow-up from January 2011 to December 2011.According to the CD4+T level of ＞ or ＜ 200/μL,We divided 102 individuals into group A (CD4+ T ≤ 200/μL),and group B(CD4+T ＞ 200/μL).The rest 87 patients were assigned to group C.The clinical symptoms,laboratory examinations,manifestations of chest X-rays,and efficacy were respectively analyzed.Results As compared with groups B and C,in group A the clinical appearance was mainly systemic symptoms;and the positive rate of laboratory examinations was lower.The chest X-ray showed more diffusepatchy andblurring shadows,commonly in multiple lung fields,and less fiber strand and cavity formation.More diffusion in multiple lung fields was seen in group B than in group C.The total effective rate was lower in group A than in groups B and C,but after the course was extended for 3 months,the total effective rate was not significantly different compared with groups B and C.Conclusions Detection of CD4+T lymphocytesin patients with suspect HIV/AIDS complicated by tuberculosis has important significance in the early diagnosis and treatment and isolation.
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