艾滋病合并结核病患者的免疫功能临床研究

目的　了解艾滋病 (AIDS)合并结核病患者的免疫功能受损情况和治疗转归。方法 分析1997年5月—2004年 3月住院的 11例AIDS合并结核病患者的CD4、CD8、HIV-RNA及PPD试验并与同期住院结核病 31例和AIDS 27例相比较。结果 AIDS合并结核病组、AIDS组与结核病组比较则CD4、CD8有显著性差异、CD3无显著性差异,而AIDS合并结核病与AIDS比较CD3、CD4、CD8均无显著性差异。 11例AIDS合并结核病中 6例检测HIV-RNA＞3.0×10⁶ copy/ml,5例HIV-RNA＜3.0×10⁶ copy/ml。而 27例AIDS中 3例HIV-RNA＞3.0×10⁶ copy/ml,24例HIV-RNA＜3.0×10⁶ copy/ml,比较有显著性差异。 结论 AIDS合并结核病者免疫功能严重受损,与结核病比较差异显著,但与AIDS比较则无明显差异。合并结核病者HIV-RNA较未合并者高,说明合并结核病者病毒复制量大,尤其是当AIDS合并血行播散性肺结核者死亡率高,抗结核治疗疗效差。

The clinic study of the immune functions in AIDS complicated with pulmonary tuberculosis

Objective To investigate the damage of immune functions in AIDS complicated with pulmonary tuberculosis and to analysis the relationship between AIDS and tuberculosis to treat and prognosis.Methods Retrospective analysis was performed in 11 cases AIDS complicated with pulmonary tuberculosis patients hospitalized from May 1997 to March 2004 cases were tested T-lymphocyte subpopulation, PPD test and HIV-RNA. These tests Results were compared with 27 AIDS cases and tuberculosis 31 cases in the same time hospitalized.Results The CD4 and CD8 cell level in peripheral blood was statistical significance difference (P＜0.01) in the AIDS with tuberculosis, and AIDS than tuberculosis.The CD3 cell level was no statistical significance (P＞0.05). 6 cases HIV-RNA viral content in AIDS with tuberculosis was＞3.0×10⁶ copy/ml,5 cases HIV-RNA viral content＜3.0×10⁶ copy/ml.It was statistical significance (P＜0.01)that it was compared with AIDS 27 cases (3cases＞3.0×10⁶ copy/ml,24cases＜3.0×10⁶ copy/ml). ALL patients alive expect for two patients dead of blood distribution of pulmonary tuberculosis.Conclusion The immune functions of AIDS complicated with tuberculosis were severe destroyed.The mortality was high in ADIS complicated blood distribution of pulmonary tuberculosis and terminal AIDS complicated with pulmonary tuberculosis. The study found AIDS complicated diffusion by blood of pulmonary tuberculosis and terminal AIDS complicated with pulmonary tuberculosis viral content was high, infective was serious, harm was verse. Treatment effect of anti-tuberculous was poor.