艾滋病合并鸟分枝杆菌感染患者临床特征初步分析
Preliminary analysis of the clinical characteristics of Mycobacterium avium infection in AIDS patients
陈钰 1李祥立 2雷素云 3张米 3张念 3杨翠先3
作者信息
- 1. 671000,大理大学公共卫生学院;650301 昆明,云南省传染病医院检验科
- 2. 650000,昆明医科大学公共卫生学院
- 3. 650301 昆明,云南省传染病医院检验科
- 折叠
摘要
目的 分析艾滋病合并鸟分枝杆菌感染患者的临床特征并与艾滋病合并其他非结核分枝杆菌(non-tuberculous mycobacteria,NTM)感染患者对比,为临床诊断与治疗鸟分枝杆菌病提供实验室数据支撑.方法 回顾性分析2016年4月—2022年6月云南省传染病医院确诊的43例艾滋病合并鸟分枝杆菌感染患者(鸟分枝杆菌感染组)及15例艾滋病合并其他类型NTM感染患者(其他种类NTM感染组)的临床资料,包括人口学特征、临床症状、影像学特征、实验室检测指标、治疗方案及预后情况等.结果 鸟分枝杆菌感染组主要临床症状为发热、咳嗽咳痰、乏力并伴体质量下降,占60.47％,其他种类NTM感染组则以发热、咳嗽咳痰、乏力为主(86.67％).2组患者均以肺部条索状、片状、结节状影伴淋巴结肿大为主,分别占51.16％ 和53.33％.鸟分枝杆菌感染组不同CD4+T细胞计数分组实验室指标整体无统计学差异,但其中CD4+T细胞101～200个/µL组与CD4+T细胞<50个/µL组患者白细胞计数与白细胞介素-6水平相比,差异均有统计学意义(H=10.316,H=16.130;P均<0.05).其他种类NTM感染组患者与鸟分枝杆菌感染组患者相比,整体各项实验室指标更接近正常值范围,不同CD4+T细胞计数与实验室指标间差异无统计学意义(P均>0.05).58例患者中35例患者经治疗后好转出院,20例患者行抗鸟分枝杆菌治疗后病情依然严重但放弃治疗,3例患者死亡.鸟分枝杆菌感染组患者与其他种类NTM感染组患者预后相比,差异无统计学意义(P=0.890).结论 结合艾滋病合并感染NTM患者人口学特征、CD4+T水平、胸部影像学特征以及临床症状,可辅助临床快速识别和诊断鸟分枝杆菌病,为患者的临床治疗及预后提供数据支撑.
Abstract
Objective To analyze the clinical characteristics of Mycobacterium avium infection in AIDS patients and compare them with non-tuberculous mycobacteria ( NTM ) infection in AIDS patients, so as to provide laboratory data support for the clinical diagnosis and treatment of Mycobacterium avium disease. Methods The clinical data of 43 patients with AIDS complicated with Mycobacterium avium and 15 cases of other types of NTM infection diagnosed in Yunnan Provincial Infectious Disease Hospital from April 2016 to June 2022 were retrospectively analyzed, including demographic characteristics, clinical symptoms, imaging features, laboratory test indicators, treatment regimens and prognosis. Results The main clinical symptoms of Mycobacterium avium infection were fever, cough and sputum, fatigue and decreased body weight ( 60.47％ ), while other types of NTM were mainly fever, cough and fatigue (86.67％). Both groups of patients were mainly characterized by linear, patchy, and nodular shadows with lymph node enlargement in the lungs, accounting for 51.16％ and 53.33％, respectively. There was no statistically significant difference in laboratory indicators among different groups of CD4+ T cell counts in the Mycobacterium avium infection group. However, there were statistically significant differences in white blood cell counts and IL-6 levels between the CD4+ T cell group with 101-200 cells/µL and the CD4+ T cell group with <50 cells/µL ( H=10.316, H=16.130; P <0.05 ). Compared with those with Mycobacterium avium infection, the overall laboratory indexes in the other NTM infection group were closer to the normal range, but there was no statistical difference between CD4+ T cell counts and laboratory indicators ( P >0.05 ). Among the 58 patients, 35 patients were discharged after treatment, 20 patients were still in serious condition after anti-Mycobacterium avium treatment but gave up treatment and were automatically discharged, and 3 patients died. There was no significant difference in prognosis between patients with Mycobacterium avium infection and other types of NTM infection ( P=0.890 ). Conclusion Combined with the demographic characteristics, CD4+ T level, chest imaging features and clinical symptoms of patients with AIDS coinfection with NTM, it can assist in the rapid identification and diagnosis of Mycobacterium avium disease, and provide data support for the clinical treatment and prognosis of patients.
关键词
非结核分枝杆菌/鸟分枝杆菌/艾滋病/临床特征Key words
non-tuberculous mycobacteria/Mycobacterium avium/AIDS/clinical characteristics引用本文复制引用
基金项目
云南省艾滋病病毒学及临床诊疗技术创新研究中心项目(202102AA310005)
中青年学术和技术带头人后备人才项目(202305AC160021)
云南省卫生健康委医学后备人才培养计划(H-2019044)
出版年
2024
NETL
NSTL
万方数据