艾滋病合并肺结核的CT表现与CD4T淋巴细胞的关系  

The Correlation between CT Appearances and CD4 T Lymphocytes in AIDS Pulmonary Tuberculosis

作　　者：朱文科[1] 陆普选[1] 余卫业[2] 刘艳[2] 刘水腾[2] 刘锦清[1] 苏坚[1] 乐晓华[3] 周伯平[2] 

机构地区：[1]广东省深圳市东湖医院放射科,518020 [2]广东省深圳市东湖医院传染科,518020 [3]广东省深圳市东湖医院病理科,518020

出　　处：《中国医学影像学杂志》2007年第4期256-259,共4页Chinese Journal of Medical Imaging

基　　金：深圳市卫生局重点科技项目(SZW2006-15)

摘　　要：目的:探讨艾滋病合并肺结核的CT表现与CD4T淋巴细胞的关系。材料和方法:回顾性分析临床确诊的23例艾滋病合并肺结核CT扫描资料,并定期CT复查以及CD4T淋巴细胞的检测,观察其HARRT及抗结核治疗后肺部病灶的动态变化。结果:病灶分布两个肺叶以上10例、中叶(舌叶)及下叶17例。大片状融合实变影9例、斑片状影6例、双肺弥漫性结节影5例和空洞影2例。纵隔及肺门淋巴结肿大15例,主要分布2R、4R区。病灶恶化进展患12例,CD4T淋巴细胞持续降低或衰竭;病灶吸收或缩小11例,早期CD4不同程度降低,3个月后CD4均有不同程度升高。结论:CT扫描能有效显示病变的各种征象,有利于艾滋病合并肺结核的诊断。CD4T淋巴细胞的量值是影响肺结核病变的动态变化及预后的重要因素。Purpose： To study the correlation between CT features and CD4 T lymphocytes in AIDS pulmonary tuberculosis. Materials and Methods： The CT features of 23 patients with AIDS pulmonary tuberculosis were analyzed retrospectively and CD4 T lymphocytes were measured regularly, at subsequently intervals, all of patients were received muhidrug antiretroviral and antitubereulous therapy. Results： The lesions located in two or more lobes in 10 cases, in middle lobe, lingular lobe, or two inferior lobes in 17cases. CT appearances of pulmonary tuberculosis including larger confluent consolidation in 9 cases, patch consolidation in 6 cases, nodular opacities widely distributed in the lung fields in 5cases,and cavities shadow in 2 cases. Fifteen cases had hilar or mediastinal lymphadenopathies. The enlarged lymph nodes were mostly located in region 2R and 4R regions. Conclusions： CT scan effectively shows a great variety of imaging signs of pulmonary tuberculosis in AIDS and is helpful to clinical diagnosis. The count of CD4 T lymphocytes is a vital factor, which influences the radiological change and prognosis of pulmonary tuberculosis.

关 键 词：获得性免疫缺陷综合征 肺结核 CD4T淋巴细胞 CT 

分 类 号：R593.31[医药卫生—内科学]