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[结核病与人类免疫缺陷病毒感染。对215例患者的前瞻性研究]

[Tuberculosis and human immunodeficiency virus infection. A prospective study of 215 patients].

作者信息

Navarro V, Guix J, Bernacer B, Nieto A, Borrás R, Ferrer C, García de Lomas J, Juan G, Roig P

机构信息

Sección de Enfermedades Infecciosas, Hospital General, Valencia.

出版信息

Rev Clin Esp. 1993 Apr;192(7):315-20.

PMID:8497737
Abstract

We analyze the cases of 215 adult patients affected from tuberculosis (TB) and infection due to human immunodeficiency virus (HIV) in the study period from December 6th, 1986 to January 31st of 1992. Disease affected specially the group of drug addict patients (DAP) with a 74.88%, followed by paid plasma donors (PPD) from our city with a 12.09%. Sexual transmission was the route of contamination with the HIV in 16 cases. In five cases atypical mycobacteria were detected. First-line anti-tuberculostatics drugs activity against Mycobacterium tuberculosis was excellent. A total of 17 cases with toxicity to any of these drugs were described. TB was located in the lung in 108 cases (50.23%), in 74 cases out of the lung (34.41%) and in 33 cases there was intrapulmonary as well as extrapulmonary affectation (15.34%). TB was diagnosed at the same time that a disease which met AIDS criteria in 13.49% of cases, TB was diagnosed first in 32.55% of cases, and AIDS was diagnosed before TB in only 7.91% of cases. Fever was the predominant symptom (88.84%), together with toxic status at admittance (80.47%) and deteriorated immune situation with lymphocytes count decrease (mean 1240/mm) and CD4 (mean value 134.5/mm) together with a mean raised IgA (492.85 mg/dl). Thorax radiography was normal in 34.88%. In 33 of these patients TB was localized in the lung, in 27.91% primary radiologic types were observed while in 31.16% reactivation types. In 51 cases (23.72%) tuberculosis was detected in patients (DAP) who were forwarded from the penitentiary system.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们分析了1986年12月6日至1992年1月31日研究期间215例成年结核病(TB)患者及人类免疫缺陷病毒(HIV)感染者的病例。疾病特别影响了吸毒成瘾患者群体(DAP),占比74.88%,其次是我市的有偿血浆捐献者(PPD),占比12.09%。性传播是16例HIV感染的途径。5例检测到非典型分枝杆菌。一线抗结核抑菌药物对结核分枝杆菌的活性极佳。共描述了17例对其中任何一种药物有毒性反应的病例。TB位于肺部的有108例(50.23%),肺外有74例(34.41%),肺内及肺外均受累的有33例(15.34%)。13.49%的病例中TB与符合艾滋病标准的疾病同时被诊断,32.55%的病例中TB先被诊断,仅7.91%的病例中艾滋病在TB之前被诊断。发热是主要症状(88.84%),入院时伴有中毒状态(80.47%),免疫状况恶化,淋巴细胞计数减少(平均1240/mm),CD4(平均值134.5/mm),同时IgA平均升高(492.85mg/dl)。胸部X线检查正常的占34.88%。其中33例患者的TB局限于肺部,27.91%观察到原发性放射学类型,31.16%为再激活类型。51例(23.72%)结核病患者是从监狱系统转来的吸毒成瘾者(DAP)。(摘要截取自250字)

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