《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (09): 739-741.

• 临床研究 • 上一篇    下一篇

HIV感染合并耐多药肺结核的成因及疗效观察

郑献民; 李松梅; 邢宝春   

  1. 新乡医学院第一附属医院结核内科 河南新乡市 453100
  • 收稿日期:2005-05-31 出版日期:2005-09-25 发布日期:2005-09-25

Cause and treatment of multi-drug resistant pulmonary tuberculosis in patients with human immunodeficiency virus infection

ZHENG Xian-min,LI Song-mei,XING Bao-chun   

  1. Department of Phthisis,the First Affiliated Hospital of Xinxiang Medical College, Weihui 453100,Henan, China
  • Received:2005-05-31 Published:2005-09-25 Online:2005-09-25

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摘要： 目的了解人类免疫缺陷病毒(HIV)感染合并耐多药肺结核(MDR-TB)的成因及治疗效果。方法对河南省某艾滋病高发地区确诊的24例HIV(+)合并耐多药肺结核进行分析。结果24例HIV(+)合并MDR-TB患者均为获得性耐药,化疗方案不合理、对患者管理不善、药物的毒副作用、免疫抑制、耐受性差为其主要原因。经过抗病毒及9～12个月抗结核治疗,死亡率29.2%(7/24),存活者痰菌阴转率88.2%(15/17),病灶吸收率94.1%(16/17),空洞缩小率66.7%(4/6),临床症状、体征有所改善,CD4+淋巴细胞数较治疗前提高(P<0.05)。结论HIV(+)合并MDR-TB,治疗困难,死亡率高,抗病毒及多药联合抗痨治疗近期效果较好。

关键词: 人类免疫缺陷病毒, 结核, 肺, 药物联合疗法

Abstract: ObjectiveTo explore the cause and treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB) in patients with human immunodeficiency virus (HIV) infection. Methods24 cases with HIV and MDR-TB who were found in some AIDS-high areas in Henan were analyzed.ResultsAll cases were later-required drug-resistant ones. The main reasons were unreasonable plan for chemotherathy,improper management to the patients, side-effect of drugs,immunosuppression and low drug-tolerance. After anti-virus and 9～12 months long anti-tuberculosis chemotherathy,7 cases died and other 17 survival patients improved in clinical symptoms and signs, including no tubercle bacillus were found in sputum of 15 cases,the focal of infection were absorbed in 16 cases,the pulmonary cavity closure rate was 66.7%(4/6)and the count of CD4+ lymphocyte was higher than before.ConclusionThe patients with HIV and MDR-TB are difficult to cure and the mortality rate is high;the short-term effect of the anti-virus and multi-drug antituberculosis chemotherathy is better.

Key words: human immunodeficiency virus, tuberculosis, pulmonary, combined drug therapy