脊柱结核并发HIV感染/AIDS患者的诊治现状与进展概述

doi:10.3969/j.issn.1000-6621.2020.05.004

摘要/Abstract

摘要：

目前,脊柱结核并发HIV感染/AIDS患者逐年增多。临床工作者对该疾病缺乏统一认识,对该疾病最新诊治手段也缺乏了解。作者就该疾病诊断的新技术、新的抗结核治疗药物及治疗方案、高效抗逆转录病毒治疗进展、手术方式进展,以及脊柱结核并发HIV感染/AIDS患者手术时的术中防护、最新研究方向等进行简要概述,以期在一定程度上统一认识,提高对该疾病的诊疗水平。

关键词: 结核,脊柱, HIV感染, 获得性免疫缺陷综合征, 诊断, 治疗, 综述

Abstract:

At present, the number of patients with spinal tuberculosis (TB) and HIV/AIDS co-infection is increasing year by year. However, the clinical health workers are lack of knowledge on the disease and the latest diagnosis and treatment methods of this disease. In view of this, the author reviewed the new diagnosis techniques, new anti-tuberculosis drugs and treatment regimens, the progress of the highly active antiretroviral therapy (HAART) and the new surgical methods, intraoperative protection of the patients with spinal tuberculosis complicated with HIV/AIDS, as well as the latest research directions, and then made a brief summary. It is hoped that, a certain extent, this paper would be helpful for the health workers to unify their understanding on the disease and improve their diagnosis and treatment level of the disease.

Key words: Tuberculosis,spinal, HIV infections, Acquired immunodeficiency syndrome, Diagnosis, Treatment, Review

蒲育, 环明苍. 脊柱结核并发HIV感染/AIDS患者的诊治现状与进展概述[J]. 中国防痨杂志, 2020, 42(5): 428-435. doi: 10.3969/j.issn.1000-6621.2020.05.004

PU Yu, HUAN Ming-cang. Overview situation and progress of diagnosis and treatment in patients with spinal tuberculosis and HIV/AIDS co-infection[J]. Chinese Journal of Antituberculosis, 2020, 42(5): 428-435. doi: 10.3969/j.issn.1000-6621.2020.05.004

参考文献 42

[1]	World Health Organization . Global tuberculosis report 2019. Geneva: World Health Organization, 2019.
[2]	刘姣, 吕冰, 颜艳 . 中国结核分枝杆菌/艾滋病病毒双重感染率分析. 中华流行病学杂志, 2013,34(1):85-90.
[3]	马远征 . 当前脊柱结核诊疗的现状与相关问题. 结核病与肺部健康杂志, 2017,6(3):201-203.
[4]	World Health Organization . WHO endorses new rapid tuberculosis test. Geneva: World Health Organization, 2010: 55.
[5]	Cheung WY, Luk KD . Clinical and radiological outcomes after conservative treatment of TB spondylitis: is the 15 years follow-up in the MRC study long enough? Eur Spine J, 2013,22(Suppl 4):594-602. doi: 10.1007/s00586-012-2332-x URL pmid: 22565800
[6]	刘保池, 李垒, 刘立 , 等. HIV感染者围手术期治疗. 中国艾滋病性病, 2010,16(5):453-455, 463.
[7]	王杨, 王丽范, 张琳焓 , 等. 骨结核与骨淋巴瘤骨骼浸润PET-CT诊断价值. 中国实验诊断学, 2019,23(8):1395-1397.
[8]	姚洪雷 . X线平片、CT、MRI对脊柱结核的诊断价值. 临床医药文献杂志, 2017,4(61) : 12003.
[9]	吴旻昊, 夏成林, 闫飞飞 , 等. 跳跃性非典型脊柱结核的临床诊断与治疗. 中国脊柱脊髓杂志, 2018,28(1):83-87.
[10]	孙春枝, 余亮, 刘阳 , 等. HIV/AIDS合并结核分枝感染的发病率的分析. 江西医药, 2015,50(12):1316-1318.
[11]	黄启标 . 脊柱结核的MRI表现与早期诊断. 影像研究与医学应用, 2019,3(4):18-19.
[12]	陆云鸥, 赵文杰, 王文伟 . PCR 荧光探针法与传统检测技术在结核病诊断中的比较. 医疗装备, 2016,29(14):13-14.
[13]	World Health Organization . Global tuberculosis report 2018. Geneva: World Health Organization, 2018.
[14]	郁大伟, 宋华峰, 邱文娜 , 等. GeneXpert MTB/RIF检测MTB及利福平耐药的应用价值. 结核病与肺部健康杂志, 2019,8(3):160-162.
[15]	王建萍, 江丽, 李平 , 等. 骨科艾滋病患者各临床分期围手术期的处理. 中国卫生产业, 2011,8(20):7-9, 11.
[16]	吴润梅, 边野, 杜勇英 . 外科手术对艾滋病感染者/患者CD4⁺水平的影响 . 预防医学情报杂志, 2019,35(12):1390-1393.
[17]	蔡娟, 张强, 肖江 , 等. 中国艾滋病患者骨科手术围术期预防. 首都医科大学学报, 2015,36(4):654-658.
[18]	韩扬 . 我国部分地区HIV/AIDS初治患者的原发耐药与亚型流行状况及特殊患者的疗效与耐药研究. 北京: 北京协和医学院, 2014.
[19]	张淑兰, 温怀凯, 陈向阳 , 等. 结核杆菌感染C-反应蛋白检测的临床意义. 浙江预防医学, 2010,22(6):12-16.
[20]	温保江, 陈栋军, 梁志勇 , 等. 不同检测方法对肺结核诊断价值的分析. 结核病与肺部健康杂志, 2018,7(2):133-136.
[21]	程红燕, 王东萍, 包训迪 , 等. 酶联免疫斑点试验在脊柱结核辅助诊断中的应用价值. 结核病与肺部健康杂志, 2017,6(4):372-376.
[22]	王馨 . 结核菌快速培养法与γ-干扰素释放试验在结核病诊断中的应用价值. 安徽医学, 2015,36(5):607-609.
[23]	Katila ML, Katila P, Erkinjuntti-Pekkanen R . Accelerated detection and identification of mycobacteria with MGIT 960 and COBAS AMPLICOR systems. J Clin Micobiol, 2000,38(3):960-964. URL pmid: 10698980
[24]	Sekido N, Igawa Y, Kakizaki H , et al. Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury. Int J Urol, 2020,27(4):276-288. doi: 10.1111/iju.14186 URL pmid: 32077161
[25]	施建党, 王自立, 耿广起 , 等. 手术并超短程化疗治疗脊柱结核的5年以上疗效观察. 中国脊柱脊髓杂志, 2013,23(6) : 481-487.
[26]	中华医学会感染病学分会艾滋病丙型肝炎学组, 中国疾病预防控制中心. 中国艾滋病诊疗指南(2018年版). 中华内科杂志, 2018,57(12) : 867-884.
[27]	Mofenson LM, Brady MT, Danner SP , et al. Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children: recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics. MMWR Recomm Rep, 2009,58(RR-11):1-166. URL pmid: 19730409
[28]	刘勇, 胡豇, 宋跃明 . 实用骨关节结核病学. 北京:科学出版社, 2018: 139-144.
[29]	何志乔, 伍静, 赵文秀 , 等. HAART及抗痨治疗艾滋病并肺结核临床研究. 中国民族民间医药, 2010,19(1):100-101.
[30]	World Health Organization . Rapid Communication: Key changes to treatment of multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB). Geneva: World Health Organization, 2019.
[31]	中国性病艾滋病防治协会学术委员会外科学组, 中华医学会热带病与寄生虫学分会外科学组. 中国人类免疫缺陷病毒感染者围手术期抗病毒治疗专家共识. 中华实验和临床感染病杂志(电子版), 2019,13(1):1-5.
[32]	杨祖群, 齐唐凯, 卢洪洲 . 艾滋病合并结核病治疗进展: 最新治疗指南及文献综述. 上海医药, 2018,39(23):27-30, 82.
[33]	张哲, 汪宇, 张玲 , 等. AIDS 合并结核性脑膜炎患者的死亡风险因素分析. 传染病信息, 2019,32(6):512-515.
[34]	Assefa A, Gelaw B, Getnet G , et al. The effect of incident tuberculosis on immunological response of HIV patients on highly active anti-retroviral therapy at the University of Gondar Hospital, Northwest Ethiopia: a retrospective follow-up study. BMC Infect Dis, 2014,14:468. doi: 10.1186/1471-2334-14-468 URL pmid: 25164855
[35]	全球首个治疗艾滋病的长效药临床三期试验达到临床终点指标. 临床合理用药杂志, 2016,9(6 中旬):181.
[36]	钱南平 . HIV/AIDS合并脊柱结核手术疗效及预后分析//中华医学会结核病学分会. 中华医学会结核病学分会2019年全国结核病学术大会论文汇编,苏州,2019. 北京: 中华医学会结核病学分会, 2019: 282-283.
[37]	刘丰胜, 贾晨光, 李卓 , 等. 脊柱结核402例围手术期处理策略. 河北医科大学学报, 2019,40(11):1269-1274.
[38]	王自立, 施建党 . 胸、腰椎脊柱结核手术方式选择的基本问题. 中华骨科杂志, 2014,34(2):232-239.
[39]	陈云生, 游辉, 陈荣春 , 等. 胸腔镜辅助下前路病灶清除植骨内固定治疗胸椎结核. 中国矫形外科杂志, 2011,19(3) : 184-187.
[40]	Fu TS, Yang SC, Tsai TT , et al. Percutaneous endoscopic debridement and drainage in immunocompromised patients with complicated infectious spondylitis. Minim Invasive Ther Allied Technol, 2010,19(1):42-47. doi: 10.3109/13645700903384450 URL pmid: 20095897
[41]	王颖博, 范伟力, 朱军 , 等. 椎间孔入路穿刺引流联合椎旁肌间隙入路内固定治疗腰骶椎结核的临床研究. 局解手术学杂志, 2017,26(12):868-872.
[42]	颜小芹, 梅长青, 龚江波 , 等. 艾滋病病人术中医护人员个人防护要点分析. 中国公共卫生管理, 2011,27(2):205-206.