Clinical Features And Curative Effect Analysis Of Tuberculosis Accompanied By HIV/AIDS Compared With Pure Tuberculosis

Objective:We analyzed the differences of clinical symptoms,laboratory parameters and chest X-ray findings between patients with HIV/AIDS accompanied by pulmonary tuberculosis and pure tuberculosis patients;besides,we compared the differences among the individuals and evaluated the curative effect among them.Methods:We collected 189 patients who were diagnosed as pulmonary tuberculosis from January 2011 to December 2015,including 105 pulmonary tuberculosis patients merged with HIV/AIDS.And 3 patients of them died due to non-tuberculosis.There were 102 patients have completed treatment and follow-up.According to whether the CD4+T lymphocyte numbers >200/ul or not,we divided patients of pulmonary tuberculosis merged with HIV/AIDS(102 cases)into two groups: Group A(CD4+T?200/ul)and Group B(CD4+T > 200/ul).Besides,87 HIV(-)patients who were under directly observed treatment short course chemotherapy(DOTS)during the same period with pure pulmonary tuberculosis were divided into group C.We evaluated the following materials such as clinical symptoms like cough,fever,asthenia,pectoralgia,chest tightness,hemoptysis,night sweats,weight loss;laboratory inspections like PPD tests,acid-fast bacillus test of sputum smear and mycobacterium tuberculosis culture;chest X-ray manifestation such as pulmonary manifestations,range of lesions and the complication of pleurisy;the efficacy and period of treatment,etc.Results :1.The clinical symptoms among the three groups were different.The accidents of fever,asthenia and weight loss in group A were higher than group B and C.Theincidence of chest tightness and hemoptysis in group A were lower than group B and C and has statistically significant.Moreover,the incidence rate of weak in group B was higher than in group C,and the differences between the two groups were statistically significant.In addition,there was no significant difference of the incidences in cough,chest tightness,night sweats among the three groups.2.The positive rates of laboratory parameters among the three groups were different.The positive rates of PPD test,acid-fast bacillus test of sputum smear and mycobacterium tuberculosis culture in group A were lower than group B and C,and the positive rate of PPD test in group B is lower than that in group C,the differences were statistically significant.Although the positive percentages of acid-fast bacillus test of sputum smear and mycobacterium tuberculosis culture in group B were lower than in group C,there was no significant difference between them.3.Through the comparison of chest radiography among the three groups,the morphology such as diffuse miliary shadows,exudative ground glass patterns and complicated with pleurisy in group A were more common than group B and C,but the fibration shade and shadows were less visible than in group B and C,the differences were statistically significant.There was no significant difference in X-ray morphology between group B and C.As for the range of lesions,the distribution in group A was often on multifocal pulmonary fields,especially on the middle and lower pulmonary field,and not so common on apex and upper lung field.This difference compared to group B and C has statistically significant.The distribution in multifocal pulmonary fields was more common in group B compared to C,these differences were statistically significant.While there was no significant difference on the apex and upper lung fields and the middle and lower pulmonary fields between group B and group C.4.The therapeutic efficacy among the three groups was different.Compared to groupB and C,group A showed lower efficacy under the same treatment activity,P<0.0017,while there was no significant difference between B group and C group.As for patients who were under therapy more than 3 month,enrolled them as A1 subunit.The total therapeutic efficacy of A1 subunit was prominently higher than group A,the difference was statistically significant.While compared A1 subunit to group B or C,there was no statistically difference.Conclusions :The clinical symptoms in group A were not typical,and the positive percentages of laboratory parameters of group A were in lower level than group B and C.Besides,individuals in group A need longer therapeutic period under the same therapeutic scheme,which were relevant to the low levels of CD4+T lymphocyte numbers.The patients complicated with HIV/AIDS,whose CD4+T lymphocyte numbers were more lower while the clinical manifestations were more untypical.These patients require longer treatment periods in order to require the equal therapeutic outcomes.Therefore,it is of great significance for patients' early diagnosis,therapy and isolation to find out the correlation between all aspects features and the CD4+T lymphocyte of patients of HIV/AIDS merged with pulmonary tuberculosis.