摘要
目的分析艾滋病(AIDS)合并结核分枝杆菌(TB)感染人群治疗方案。方法选择2013年2月至2015年10月收治的100例艾滋病合并结核分枝杆菌感染患者为研究对象。入院后患者均进行CD4^+T淋巴细胞计数检查。按CD4^+T淋巴细胞计数结果将患者分为4组:A组(CD4^+T淋巴细胞计数≤50μL^(-1),n=25)、B组(50μL^(-1)<CD4^+T淋巴细胞计数≤200μL^(-1),n=26)、C组(200μL^(-1)<CD4^+T淋巴细胞计数≤350μL^(-1),n=24)和D组(CD4^+T淋巴细胞计数>350μL^(-1),n=25)。按照随机数字表法将这4组另分为2个亚组,即A、B、C、D组分别分为对照一组(n=12)和观察一组(n=13)、对照二组(n=13)和观察二组(n=13)、对照三组(n=12)和观察三组(n=12)、对照四组(n=12)和观察四组(n=13)。最后将对照一、二、三、四组共49例患者归为对照组,观察一、二、三、四组共51例患者归为观察组。对照组予抗结核治疗2周后再同时予抗病毒治疗,观察组抗结核治疗4周后再同时予抗病毒治疗,2组具体用药相同,抗结核治疗疗程均为1年,抗病毒药物则一直服用。比较不同方案的治疗效果。结果治疗8周后,对照组与观察组患者治愈率、病死率、治疗失败率及不良反应发生率比较差异无统计学意义(P>0.05),对照组总医疗费用明显高于观察组(P<0.05)。治疗4周,对照组与观察组病毒抑制率比较差异无统计学意义(P>0.05);治疗8周,对照组病毒抑制率低于观察组(P<0.05)。结论 AIDS合并TB感染患者抗结核治疗2周后进行ART治疗与抗结核治疗4周后进行ART治疗疗效无明显差异性,临床应针对患者实际情况择优选择治疗方案。
Objective To analyze the treatment regimens for acquired immune deficiency syndrome（AIDS） complicated by Mycobacterium tuberculosis（M.tb） infection. Methods One hundred patients treated between February 2013 and October 2015 for AIDS and M.tb infection were enrolled in this study. According to CD4＋ T lymphocyte counts, patients were divided into four groups：group A（CD4＋ T lymphocyte count≤50 μL 1 ,n=25）,group B（50 μL-1〈CD4＋T lymphocyte count 4200 μL-1,n=26） ,group C（200 μL-1〈CD4＋ T lymphocyte count 4350 μL-1,n=24） ,and group D（CD4＋ T lymphocyte count 〉350 μL-1,n= 25）.Furthermore,each group was randomly divided into two subgroups： group A,control group 1（n= 12） and observation groul （n=13） ;group B,control group 2（n=13） and observation group 2（n=13）;group C, control group 3（n =12） and observation group 3（n=12） ;group D,control group 4（n=12） and observa received 2 weeks of an groups 14（observation group） received 4 weeks of antituberculosis therapy and subsequent anti viral treatment. The course of antituberculosis therapy was 1 year. Therapeutic effect was corn pared between control group and observation group.Results After treatment for 8 weeks, there were no significant differences in cure rate, mortality rate, treatment failure rate and adverse reac tion rate between the two groups（P 〉0.05）. However, compared with observation group, the total medical costs increased and the virus inhibition rate decreased in control group（P〈0.05）.After 4 weeks of treatment, no significant difference was found in virus inhibition rate between the two groups（P〉0.05）.Conclusion The curative efficacy of 2 weeks of antituberculosis therapy and subsequent antiviral treatment is not different from that of 4 weeks of antituberculosis therapy and subsequent antiviral treatment for AIDS complicated by M. tb infection. The treatment regi mens should be selected according to the actual situation of patients.
作者
孙春枝
邓爱花
熊玉红
刘阳
涂小云
SUN Chun-zhi;DENG Ai-hua;XIONG Yu-hong;LIU Yang;TU Xiao-yun(Department of Internal Medicine,Jiangxi Chest Hospital,Nanchang 330100,China)
出处
《实用临床医学（江西）》
CAS
2018年第8期5-7,34,共4页
Practical Clinical Medicine
基金
江西省科技支撑计划项目(1456)
关键词
艾滋病
结核分枝杆菌
治疗
acquired immune deficiency syndrome
Mycobacterium tuberculosis
treatment
