关键词: 获得性免疫缺陷综合征, 纵隔, 淋巴结结核, 疗效

Abstract: Objective To compare and analyze the size changes of primary treatment of tuberculosis of mediastinal lymph nodes in patients with AIDS and non-AIDS ,and to assess the efficacy of anti-tuberculous therapy in patients with AIDS combined with mediastinal lymph node tuberculosis.Methods Between January 2016 and December 2019,Clinical and CT scan data of patients with AIDS and non-AIDS combined with mediastinal nodal tuberculosis in Nanning Fourth People's Hospital were analyzed,and the patients of AIDS combined with mediastinal nodal tuberculosis as the observation group,the non-AIDS as the control group.The treatment of nodal tuberculosis was 2-3HRZE / 9-15HRE.Compared the clinical manifestations before the treatment between the two groups,Assessed the efficacy of anti-tuberculous therapy through observing the transformation of the lymph gland size at 1 month,2 month,4 month,6 month,8 month,12 month and above.Results There were no statistically significant differences in gender and age between the two groups.Before treatment,In observation group,the detection rate of MTB complex group was lower than the control group,the fever rate was higher (P<0.001),CD4+T cells were significantly lower (Z=-5.565,P<0.001),and the first hospital stay was longer (P=0.046).There were no statistically significant differences in cough and sputum (P>0.05).The incidence of hemoperatively disseminated pulmonary tuberculosis (including secondary pulmonary tuberculosis combined with hemoperatively disseminated pulmonary tuberculosis) in observation group was higher than that in control group (χ²=4.227,P=0.040).There was no statistically significant difference between the two groups in efficacy of anti-tuberculous therapy at 1Month,2Month,4Month,6Month,8Month,12Month or above (P>0.05).After 7 days-6months of Highly Active Antiretroviral Therapy (HAART),12 patients in observation group were repeatedly hospitalized because of tuberculosis-associated immune reconstruction syndrome (TB-IRIS).Conclusions The anti-tuberculosis treatment of AIDS patients combined with mediastinal lymph node tuberculosis and non-AIDS patients combined with mediastinal lymph node tuberculosis had similar efficacy and was not affected by HAART combined treatment.Follow-up with CT can be used to evaluate the anti-tuberculosis efficacy of AIDS patients combined with tuberculosis of mediastinal lymph nodes,especially in the early stage of HAART,which is conducive to the early clinical diagnosis of TB-associated immune reestablishment inflammatory syndrome.

Key words: Acquired immune deficiency syndrome, Mediastinum, Lymph node tuberculosis, Efficacy