HIV感染者和AIDS患者并发肺结核的CT表现  

CT Findings of Pulmonary Tuberculosis in the Patients with HIV Infection and AIDS

作　　者：陈碧华[1] 刘晋新[1] 唐小平[1] 江松峰[1] 张烈光[1] 黄德扬[1] 

机构地区：[1]广州市第八人民医院放射科,广东广州510060

出　　处：《实用放射学杂志》2009年第12期1730-1733,共4页Journal of Practical Radiology

基　　金：广州市科技攻关计划项目（2006Z3-E0431,2006Z1-E0091）,广州市医药卫生科技项目（2005-Zdi-04）.

摘　　要：目的探讨HIV感染者和艾滋病患者（HIV／A1Ds）并发肺结核的CT表现特征。方法回顾性分析48例HIV／AIDs并发肺结核的CT表现。结果HIV／AIDS患者肺结核的CT表现为：继发型肺结核19例（39.6％），病变形态以斑片状阴影为主，10例可见融合成大片的实变影；血行播散型肺结核17例（35.4％），其中急性粟粒型肺结核7例，表现为大小、分布均匀的粟粒影，而亚急性血行播散型10例，表现为大小、分布不均匀的粟粒、小结节影；多种征象混合表现10例（20.8%），表现为双肺斑片状渗出病灶与弥漫分布的粟粒、小结节灶相混杂。纵隔淋巴结肿大36例（75.0％），胸腔积液13例（27.1％），心包积液10例（20.8％）。结论HIV／AIDS并发肺结核的CT特征为局灶性肺实质病变较少而弥漫性的病变较多。Objective To evaluate CT features of pulmonary tuberculosis in the patients with HIV infection and AIDS（HIV/ AIDS）. Methods CT findings of pulmonary tuberculosis were retrospectively analyzed in 48 patients with HIV/AIDS. Results The CT features of pulmonary tuberculosis in HIV/AIDS included： secondary pulmonary tuberculosis in 19 cases（39.6%）, mostly showing patchings shadows, 10 cases with large confluent consolidation; hematogenous pulmonary tuberculosis in 17 eases（35.4M）, including 7 cases of acute miliary tuberculosis（showing miliary lesions evenly distributed in both lungs）, and 10 cases of sub-acute disseminated tuberculosis（showing nodular patterns diffusely distributed in both lungs, asymmetrical in size and distribution）; complex lesions in 10 cases（20.8%, showing patchy, nodular and miliary lesions）. Among all the patients, 36（75.0%） showed enlarged mediastinal lymphnodes, 13（27.1%） pleural effussion, 10 （20.8%） pericardial effusion. Conclusion The characteristics of pulmonary tuberculosis in the patients with HIV/AIDS were mostly diffuse distribution.

关 键 词：肺 人类免疫缺陷病毒 获得性免疫缺陷综合征 肺结核 体层摄影术 x线计算机 

分 类 号：R593.32[医药卫生—内科学] R521[医药卫生—临床医学]