艾滋病合并肺结核肺部影像学表现及其流行病学研究分析(附48例报告)  

The Analysis of the Lung Imageological and Epidemiological Characteristic in Patients of AIDS Complicated by Pulmonary Tuberculosis( PTB)( Report of 48 Cases)

作　　者：林焕兴 叶演红[2] 袁彩霞 樊安华 王天理 

机构地区：[1]广东省深圳市龙岗区慢性病防治院影像科,518172 [2]广东省深圳市龙岗区人民医院信息科,518172 [3]广东省深圳市大鹏新区葵涌人民医院社康中心,518197

出　　处：《现代医用影像学》2013年第5期349-352,共4页Modern Medical Imageology

摘　　要：目的：探讨艾滋病（AIDS）合并肺结核（PTB）的肺部影像学表现及其流行病学研究。材料与方法：回顾性分析48例艾滋病合并肺结核的肺部影像学表现，48例均行DR胸片检查，其中32例行CT检查。结果：流行病学研究显示AIDS合并PTB的80％以上为年青人，男性占64％，16～35岁年龄段占绝大多数，流动人口约占83％，有抽烟及吸毒嗜好者占93％，其他约占7％。48例艾滋病合并肺结核患者中浸润型肺结核伴胸腔积液26例，血行播散型肺结核14例，慢性纤维空洞型肺结核8例，病变大多为大片状、斑片状或小片状密度增高影，边缘模糊，密度不均，其中可有空洞、小结节、肺门或／和纵隔淋巴结肿大等混杂存在，往往双肺多叶、段不同程度受累，病灶多呈融合趋势。结论：艾滋病合并感染肺结核后，多种性质的病灶共存，双肺多叶、段分布，呈多形态表现，但确诊有赖于HIV血清抗体试验及痰的细菌学检查。Purpose： To investigate the lung imageological and epidemiologieal characteristic in patients of. AIDS combined with pulmonary tuberculosis （PTB）. Materials and Methods： A retrospective analysis was adopted to study the lung imaging findings of 48 cases of AIDS with pulmonary tuberculosis, chest radiography DR was applied for all, and CT. was used for 32 cases. Results： Epidemiological study had shown that more than 80 percent cases were young people, men accounted for 64% , the majority age group was 16 to 35, migrant population accounted for about 83 percent, cases with smok- ing and drug addiction accounted for 93 percent, and others was about 7 percent. Among all the 48 cases, 26 patients were suffered with infiltrative pulmonary tuberculosis combined with pleural effusion; 14 patients developed as hematogenous dis- seminated pulmonary tuberculosis, 8 cases suffered with chronic fibro-cavernous pulmonary tuberculosis. Mostly appeared with density shadow of large patchy lesions, patchy or small flake , and edge unsharpness, which confound with hollows, small nodules, lymphadenectasis in hilum of lung and / or mediastinal, lobes and segments of both lung were involved in var- ying degrees, the lesions mostly developed to be confluent. Conclusion： In patients of AIDS co-infection of tuberculosis, mixed lesions coexists, which are distributed over multiple lobes and segments of both lung, showing performance of multi- form, but the diagnosis depends on the HIV antibody and sputubacteriological test.

关 键 词：艾滋病 肺结核 影像学 流行病学 

分 类 号：R512.91[医药卫生—内科学] R521[医药卫生—临床医学]