艾滋病合并分枝杆菌肺病的CT研究  

CT features of pulmonary mycobacterial disease in patients with acquired immunodeficiency syndrome

作　　者：朱莹[1] 张志勇[1] 施裕新[1] 冯峰[1] 

机构地区：[1]复旦大学附属公共卫生临床中心上海市公共卫生临床中心放射科,201508

出　　处：《中华放射学杂志》2013年第1期23-27,共5页Chinese Journal of Radiology

基　　金：国家自然科学基金资助项目（81071153）

摘　　要：目的探讨艾滋病（AIDS）合并非结核分枝杆菌（NTM）肺病的胸部影像特征及其与AIDS合并肺结核（TB）的胸部CT表现差异，提高诊断AIDS合并分枝杆菌肺病的正确率。方法回顾性分析27例AIDS合并NTM肺病的胸部CT表现，对照30例AIDS合并肺TB的CT表现，并用Fisher确切概率法对其影像表现进行统计学分析。结果NTM的CT征象显著高于肺TB的为：结节影（18和1例，P〈0．01）、磨玻璃密度结节影（10和0例，P〈0．01）、条索影（17和3例，P〈0．01）、支气管扩张（9和2例，P=0．012）。NTM显著低于肺TB的CT征象为：粟粒结节影（0和6例，P=0．016）、斑片影（2和11例，P〈0．01）、胸腔积液（1和9例，P〈0．01）。结论AIDS合并NTM肺病胸部CT表现以结节影、条索影为主，常合并支气管扩张；AIDS合并肺TB以渗出性（斑片影）病变为主，常合并胸腔积液，此外粟粒型病变较NTM常见。Objective To study the CT features of pulmonary non-tuberculous mycobacteria （NTM） disease in patients with acquired immunodefieiency syndrome （AIDS） and explore the different CT appearances between AIDS-NTM and AIDS-TB. Methods CT findings of pulmonary NTM disease in 27 AIDS patients （ NTM group） were retrospectively analyzed and compared with that of tuberculosis in 30 AIDS patients （TB group）. The results were statistically analyzed using Fisher＇s exact test. Results CT findings of NTM appeared significantly more than that of TB as follows： high-density nodules （n = 18 vs 1, P〈0.01）,ground-glass opacities （n = 10 vs 0,P 〈0.01）,fibrotic band （n = 17 vs 3,P 〈0.01）, bronchiectasis （9 vs 2, P = 0. 012 ）. CT findings of NTM appeared significantly less than that of TB as follows ： miliary nodules （ 0 vs 6, P = 0. 016 ） , air space consolidations （ n = 2 vs 11, P 〈 0. 01 ） , pleural effusion （ n = 1 vs 9, P 〈 0. 01 ）. Conclusion Nodule and fibrotic band companied with bronchiectasis were the main CT manifestations of pulmonary NTM disease in AIDS patients, while air space consolidation eompanied with pleural effusion and miliary nodules were the predominate CT findings of pulmonary tuberculosis in AIDS patients.

关 键 词：获得性免疫缺陷综合征 分枝杆菌 非典型性 体层摄影术 螺旋计算机 

分 类 号：R512.91[医药卫生—内科学]