摘要
目的分析湖南省结核病并发HIV感染患者的流行病学及临床特征，为其防治提供可靠的参考依据。方法收集2013—2017年湖南省胸科医院收治的157例结核病并发HIV感染患者，作为观察组；并通过分层随机抽样方法，从同期本院收治的未感染HIV的结核病患者中抽取200例作为对照组，对两组患者的社会学特征、临床特征、实验室检测等指标，以及结核病并发HIV感染患者的影响因素进行统计分析。结果单因素分析结果显示，男性（125例，79．6％）、年龄在20-60岁[其中20-39岁55例（35．0％）、40～60岁79例（50．3％）]、已婚（102例，65．0％）、发热（70例，44．6％）、颈部肿块（31例，19．7％）、腹胀（9例，5．7％）、腹痛（10例，6．4％）、淋巴结结核（50例，31．8％）、并发梅毒感染（32例，23．0%）的结核病患者更易被检出HIV感染，差异均有统计学意义（X2值分别为7．55、21．31、15．06、49．98、15．70、4．85、5．95、22．39、25．05，P值分别为0．006、0．000、0．005、0．000、0．000、0．028、0．015、0．000、0．000）；结核抗体、结核感染T细胞斑点试验（T-SPOT．TB）检测在观察组的阳性检出率[16．8％（25／149）和61．7％（50／81）]均低于对照组[34．1％（60／176）和78．2％（86／110）]，差异均有统计学意义（X2值分别为12．52、6．45，P值分别为0．000、0．040）。多因素分析结果显示，结核病患者中20-39岁和40-60岁年龄组是影响结核病并发HIV感染的危险因素EoR值（95％CI值）分别为12．54（1．53～102．89）、9．09（1．20～69．40）]；临床表现为发热、淋巴结结核、并发梅毒感染在结核病并发HIV感染患者中的比率更高EoR值（95％CI值）分别为6．51（2．35～18．01）、5．80（1．93-17．41）、15．06（2．71-83．84）；结核病并发HIV感染患者并发支气管结核的比率更低[0R值（95％
Objective To understand the epidemiology and clinical features of tuberculosis and HIV co-infec- ted patients in Hunan province and provide a reliable reference for its prevention and treatment. Methods A total of 157 tuberculosis and HIV co-infected patients were enrolled from 2013 to 2017 in Hunan Chest Hospital, and 200 patients were selected from the non-HIV-infected tuberculosis patients as controls by stratified random sampling method. Data on the sociological characteristics, clinical features and results of laboratory tests were collected, and statistical analysis was conducted to identify the risk factors for tuberculosis complicated with HIV infection. Results Univariate analysis showed that male tuberculosis patients （125 cases, 79.6~/oo）, patients who aged 20--60 years old （20--39 years old, s5 （35.0%） cases; 40--60 years old： 79 （50.3%） cases, married patients （102 cases, 65.0~）, patients who suffered from fever （70 cases, 44.6~）, neck mass （31 cases, 19.7%）, abdominal disten- sion （9 cases, 5.7%）, abdominal pain （10 cases, 6.4%） or lymphatic tuberculosis （50 cases, 31.8~）, and pa- tients complicated with syphilis infection （32 cases, 23.0%） were more likely infected with HIV. The differences were statistically significant （%2 values were 7.55, 21.31, 15.06, 49.98, 15.70, 4.85, 5.95, 22.39, and 25.05; P values were 0. 006, 0. 000, 0. 005, 0. 000, 0. 000, 0. 028, 0. 015, 0. 000, and 0. 000, respectively）. The positive detection rates of tuberculosis antibody and tuberculosis infection T-cell spot test （T-SPOT. TB） in the double infec- tion group （16.8% （25/149） and 61.7~ （50/81）） were lower than those in the non-HIV-infected tuberculosis group （34.1% （60/176） and 78.2% （86/110））. The differences were statistically significant （%2 values were 12.52 and 6.45; P values were 0. 000 and 0. 040, respectively）. Multivariate analysis showed that among the TB patients, age of 20-39 and 40-60 were risk factors influencing the double
作者
刘彬彬
王珏
陈振华
余艳艳
刘丰平
谭云洪
LIU Bin-bin;WANG Jue;CHEN Zhen-hua;YU Yan-yan;LIU Feng-ping;TAN Yun-hong(Department of Clinical Laboratory, Hunan Institute for Tuberculosis Control, Hunan Chest Hospital, Changsha 410013, China)
出处
《中国防痨杂志》
CAS
2018年第7期750-755,共6页
Chinese Journal of Antituberculosis
关键词
分枝杆菌
结核
HIV
重叠感染
流行病学研究
疾病特征
Mycobacterium tuberculosis
HIV
Superinfection
Epidemiologic studies
Disease attributes
