不同机构来源HIV阳性结核病患者抗结核治疗效果分析

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目的比较来自艾滋病防治机构(简称“艾防机构”)和结核病防治机构(简称“结防机构”)的HIV阳性结核病患者的特征及抗结核治疗效果。方法从结核病信息管理系统中导出6省14个县2年时间结核病患者患病和治疗的相关信息,从艾滋病防治机构收集HIV阳性患者的相关信息。从2007年9月1日至2009年8月31日期间共登记报告HIV检测阳性的肺结核患者925例。673例(72.8%)为艾防机构转诊的已知HIV阳性患者,252例(27.2%)为结防机构新检出HIV阳性患者。结果在HIV主要由采供血传播的地区,艾防机构转诊的HIV阳性结核病患者和结防机构新发现的HIV阳性结核病患者治疗成功率分别为90.6%(328/362)和82.4%(70/85)(χ2=4.806,P=0.034),病死率分别为7.5%(27/362)和16.5%(14/85)(χ2=6.711,P=0.010)。在HIV主要通过吸毒和性传播的地区,艾防机构和结防机构发现的患者治疗成功率分别为60.1%(187/311)和68.9%(115/167)(χ2=3.563,P=0.059),不良反应率分别为24.1%(75/311)和13.8%(23/167)(χ2=7.132,P=0.009)。结论应继续加强在HIV感染者与AIDS患者中筛查结核病的工作,同时在结核病患者中筛查HIV感染也是一项很重要的挽救措施。 Objective To compare the characteristics of HIV-positive TB patients from AIDS prevention agencies (referred to as “AIDS prevention agencies”) and TB prevention and control agencies (“SARS prevention and control agencies” for short) and the results of anti-TB treatment. Methods The TB information management system was used to derive information about the prevalence and treatment of tuberculosis patients in 14 counties in 6 provinces in two years and to collect relevant information from HIV / AIDS prevention and control institutions for HIV positive patients. From September 1, 2007 to August 31, 2009, a total of 925 reported cases of HIV-positive tuberculosis were reported. 673 (72.8%) were HIV-positive patients referred by EAPA, and 252 (27.2%) were newly detected HIV-positive patients. Results The successful treatment rates of HIV-positive TB patients newly discovered by EAP agencies and HIV-positive tuberculosis patients referred by EAP agencies were 90.6% (328/362) and 82.4% (70 / (Χ2 = 4.806, P = 0.034). The case fatality rates were 7.5% (27/362) and 16.5% (14/85) respectively (χ2 = 6.711, P = 0.010). In the areas where HIV was predominantly drug-induced and sexually transmitted, the success rates of treatment were 60.1% (187/311) and 68.9% (115/167), respectively (χ2 = 3.563, P = 0.059) The rates of adverse reactions were 24.1% (75/311) and 13.8% (23/167), respectively (χ2 = 7.132, P = 0.009). Conclusions The screening of tuberculosis in HIV-infected and AIDS patients should continue to be strengthened. Screening for HIV infection among tuberculosis patients is also an important saving measure.
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