12例艾滋病患者泌尿系结核的临床特征分析

摘要/Abstract

摘要： 目的: 分析艾滋病患者泌尿系结核的临床特征,提高对该病的认识,避免漏诊,及时诊治。方法: 收集2017年10月至2022年9月深圳市第三人民医院住院部收治的符合诊断标准的12例艾滋病并发泌尿系结核患者的临床资料进行分析。结果: 12例患者中,男性11例,女性1例,年龄中位数（四分位数）为32.5（26.5,51.5）岁。并发肺结核10例（其中血行播散性肺结核3例）,肠结核5例,结核性脑膜脑炎2例,颈淋巴结结核1例。12例均无典型泌尿系症状;尿白细胞异常者3例。结核感染T淋巴细胞斑点试验（T-SPOT.TB）阳性者9例。10例行泌尿系彩超或CT扫描仅发现2例异常（分别为双肾实质回声增粗及左肾积水）,2例肾功能轻度异常;10例CD4细胞计数<100个/ul且HIV病毒载量高于检测下限;尿结核菌检测情况：10例涂片抗酸阳性2例,分子生物学检测（GeneXpertMTB/RIF）阳性12例（耐利福平2例）,10例行分枝杆菌BACTEC MGIT 960快速培养阳性4例。结论: 深圳市艾滋病患者中泌尿系结核起病隐匿,早期症状不典型;常并发其他器官或部位结核;多见于CD4细胞明显降低者;血T-SPOT.TB检测多呈阳性;尿白细胞、肾功能、泌尿系影像学检查可表现正常,容易漏诊;尿液结核分子生物学检测（GeneXpertMTB/RIF）阳性有助于及早诊断。

关键词: 获得性免疫缺陷综合征, 结核, 泌尿系统, 临床特征

曾坚, 王瑾, 方木通, 傅佳鹏, 卢水华. 12例艾滋病患者泌尿系结核的临床特征分析[J]. 中国防痨杂志, 2024, 46(S1): 33-36.

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