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目的分析结核分枝杆菌(TB)感染的诊断技术在艾滋病合并TB感染诊断中的应用效果。方法回顾性分析265例艾滋病合并TB感染患者,记录临床常用的TB感染实验室、影像学、组织病理学诊断结果和CD4+T淋巴细胞计数,分析其相关性。结果 265例患者中,临床表现为肺结核127例,肺结核并肺外结核80例,肺外结核58例(21.9%)。两者的CD 4+T淋巴计数分别为(107.10±99.55)(、44.24±43.15)(、50.64±66.60)/μl,三组两两比较均有统计学差异(P均<0.01)。不同诊断技术在肺结核、肺结核并肺外结核、肺外结核患者中的阳性率分别为痰涂片13.5%、6.3%、0,胸片21.1%、12.5%、3.4%,CT 61.0%、52.4%、15.8%,γ-干扰素释放试验75.0%、100%8、3.3%,支气管镜检查36.4%2、5.0%、0,组织病理检查54.5%、71.4%、63.6%。结论在CD 4+T淋巴计数较低的艾滋病合并TB感染者的诊断中,γ-干扰素释放试验、支气管镜检查、组织病理检查受CD4+T淋巴计数高低影响小,使用综合诊断技术有助于提高诊断水平。
Objective To analyze the diagnostic value of mycobacterium tuberculosis (TB) infection in the diagnosis of AIDS complicated with TB infection. Methods A retrospective analysis of 265 cases of HIV infection with TB infection in patients with TB infection laboratory records, imaging, histopathological diagnosis and CD4 T lymphocyte count, analyze the correlation. Results Among the 265 patients, 127 cases were pulmonary tuberculosis, 80 cases were pulmonary tuberculosis and extrapulmonary tuberculosis, and 58 cases were extrapulmonary tuberculosis (21.9%). The CD 4 + T lymphocyte counts of the two groups were (107.10 ± 99.55), (44.24 ± 43.15), (50.64 ± 66.60) / μl, respectively. There was significant difference between the two groups (P <0.01). The positive rates of different diagnostic techniques in patients with pulmonary tuberculosis, pulmonary tuberculosis and extrapulmonary tuberculosis were: sputum smear 13.5%, 6.3%, 0, chest radiograph 21.1%, 12.5%, 3.4%, CT 61.0%, 52.4% , 15.8%, γ-interferon release test 75.0%, 100% 8,3.3%, bronchoscopy 36.4% 2, 5% 0, histopathological examination 54.5%, 71.4%, 63.6%. Conclusions In the diagnosis of HIV-infected TB patients with low CD 4 + T lymphocyte count, the interferon-γ release test, bronchoscopy and histopathological examination are less affected by the level of CD4 + T lymphocyte count. The use of comprehensive diagnostic techniques is helpful To improve the diagnostic level.