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目的:对照分析艾滋病合并肺结核与单纯肺结核临床表现。方法:2005年10月至2015年10月艾滋病合并肺结核患者共计352例,设置为艾滋病合并肺结核组。另选择符合相同时间段的单纯肺结核患者350例,设置为单纯肺结核组。对两组患者的临床表现、痰液涂片培养结果及影像学检出情况进行临床对照分析。结果:艾滋病合并肺结核组患者发热、体重下降临床症状发生率分别为87.80%(302/352)、100%(352/352),均明显高于单纯肺结核组(P<0.05)。艾滋病合并肺结核组患者抗酸染色、痰结核分歧杆菌、血清结核抗体、PPD阳性检出率均明显低于单纯肺结核组(P<0.05)。艾滋病合并肺结核组患者影像学显示空洞率为11.08%(39/352),明显低于单纯肺结核组[30.00%(105/350),P<0.05]。结论:艾滋病合并肺结核患者的临床表现缺乏显著特异性,以发热、体重下降为主,临床需依据疾病特征,综合痰液培养、影像学结果作出明确诊断,以早期明确治疗。
Objective: To compare and analyze the clinical manifestations of AIDS complicated with tuberculosis and simple tuberculosis. Methods: From October 2005 to October 2015, a total of 352 cases of AIDS-TB patients were enrolled. They were set as HIV-infected patients with pulmonary tuberculosis. In addition, 350 patients with simple pulmonary tuberculosis who meet the same time period were selected and set as simple tuberculosis group. The clinical manifestations of two groups of patients, sputum smear culture results and imaging detection of clinical control analysis. Results: The incidence of clinical symptoms of fever and weight loss in patients with AIDS complicated with pulmonary tuberculosis were 87.80% (302/352) and 100% (352/352), respectively, which were significantly higher than those in patients with simple pulmonary tuberculosis (P <0.05). In the AIDS-combined TB group, the positive rates of acid-fast staining, Mycobacterium tuberculosis, serum TB antibody and PPD were significantly lower than those in the simple pulmonary tuberculosis group (P <0.05). The imaging rate of patients with AIDS complicated with pulmonary tuberculosis was 11.08% (39/352), significantly lower than that of patients with simple pulmonary tuberculosis [30.00% (105/350), P <0.05]. Conclusion: The clinical manifestations of AIDS patients with tuberculosis lack of significant specificity, with fever, weight loss based clinically based on disease characteristics, comprehensive sputum culture, imaging findings to make a clear diagnosis of early clear treatment.