艾滋病机遇性胸部感染的X线平片表现  

Radiographic Features of Opportunity Chest Infection in Patient with AIDS

作　　者：朱文科[1] 陆普选[1] 单鸿[2] 余卫业[3] 刘艳[3] 杨根东[1] 刘锦清[1] 臧建[1] 

机构地区：[1]广东省深圳市东湖医院放射科,518020 [2]中山大学附属第三医院放射科,广州510630 [3]广东省深圳市东湖医院传染病科,518020

出　　处：《中国医学影像学杂志》2005年第3期202-205,共4页Chinese Journal of Medical Imaging

摘　　要：目的:提高艾滋病机遇性胸部感染的诊断水平。材料和方法:回顾性分析艾滋病机遇性胸部感染50例的X线胸片及相关临床资料。结果:肺结核2 1例( 4 2 % ) ,片状融合的渗出性病灶1 3例,弥漫性粟粒影6例;胸内淋巴结肿大9例;卡氏肺囊虫肺炎1 6例( 32 % ) ,双侧肺门及中下肺野可见网状、小点状影,片絮状或斑片状影1 0例,两肺弥漫性或局限性磨玻璃影8例;细菌性感染8例( 1 6 % ) ,片状实变影7例,肺结块影并空洞1例;真菌性感染5例( 1 0 % ) ,弥漫粟粒样小结节影3例,肺门淋巴结肿大1例。结论:艾滋病机遇性胸部感染的X线表现缺乏特征性,诊断须结合临床与实验室检查,并注意发病率较高的肺结核与卡氏肺囊虫肺炎。Purpose: To improve the radiographic diagnosis of opportunity chest infection in patient with acquired immunodeficiency syndrome (AIDS). Materials and Methods: The radiographic features and clinical data of 50 AIDS patients with opportunistic chest infection were retraspectively analysed. Results: The radiographic appearances of 21(42%) patients with pulmonary tuberculosis (PTB) included patchy confluent exudative foci (13 cases), diffuse military tuberculosis ( 6 cases ), enlarged intrathoracic lymph nodes ( 9 cases). Of 16 (32%) patients with pneumocystis carnii pneumonia (PCP), 10 had diffuse reticular or reticulo-nodular infiltrates and alveolarconsolidation, and 8 had ground-glass change with bilateral hilar regions and middle-lower lunge fields. 8 (16%) patients with bacterial pneumonia revealed focal consolidation which typically presented in either a segmental or lobar distribution (7 cases ), and lunge nodules and cavities(1 case ). 5 (10%) patients with fungus pneumonia showed military nodules (3 cases) and lymphadenopathy (1 case ). Conclusion: Radiographic findings of opportunity chest infections in patient with AIDS are often nonspecific for pneumonias, so diagnosis must be associated with clinic and laboratory data. Both PTB and PCP should firstly be taken into consideration once pulmonary abnormal is present.

关 键 词：胸部感染 机遇性 艾滋病 X线平片表现 卡氏肺囊虫肺炎 肺门淋巴结肿大 回顾性分析 渗出性病灶 细菌性感染 真菌性感染 实验室检查 诊断水平 临床资料 X线胸片 中下肺野 斑片状影 磨玻璃影 X线表现 肺结核 弥漫性 结节影 

分 类 号：R561.02[医药卫生—呼吸系统] R563.04[医药卫生—内科学]