免疫重建炎性综合征艾滋病患者胸部淋巴结 CT 表现  

CT appearance of thoracic lymphonodus in AIDS patients with immune reconstitution inflammatory syndrome

作　　者：宋树林[1] 卢亦波[1] 覃春乐[1] 许承志[1] 黎之利[1] 

机构地区：[1]广西艾滋病临床治疗中心 南宁 南宁市第四人民医院放射科,广西 南宁530000

出　　处：《实用放射学杂志》2015年第10期1617-1619,1627,共4页Journal of Practical Radiology

基　　金：广西医药卫生科研课题项目（Z2013685）.

摘　　要：目的：探讨经高效抗逆转录病毒治疗发生免疫重建炎性综合征（IRIS）的艾滋病患者胸部淋巴结 CT 表现。方法收集24例经高效抗逆转录病毒治疗后发生免疫重建炎性综合征出现胸部淋巴结增大的艾滋病患者胸部 CT 资料,分析其胸部 CT 表现。结果24例艾滋病患者合并肺结核19例,其中5例合并颈部淋巴结结核,合并马尔尼菲青霉菌感染1例,合并卡氏肺孢子菌感染1例,合并细菌、真菌混合性感染3例。24例患者胸部增大淋巴结分布于不同部位,主要位于4R 区（20/24）,其次见于2R 区（11/24）,4L 区（11/24）,其密度均匀或不均匀,边界清楚或不清楚,部分淋巴结融合,无钙化。X 区淋巴结短径约23.0~42.0 mm,其他区淋巴结短径约11.0~25.0 mm。2例增强扫描淋巴结均匀强化；2例10R 区淋巴结增大患者出现阻塞性肺炎、肺实变；13例出现胸腔积液,最深约22 mm；5例出现心包积液,最深约24 mm。结论艾滋病发生免疫重建炎性综合征患者胸部增大淋巴结可见于不同部位,主要累及4R、2R、4L 区,伴或不伴胸腔积液、心包积液。Objective To explore the CT appearance of thoracic lymphonodus in AIDS patients with immune reconstitution in-flammatory syndrome（IRIS）after highly active antiretroviral therapy （HAART）.Methods The data of thoracic CT in 24 AIDS pa-tients after HAART with enlarged thoracic lymphonodus in IRIS were collected,and the chest CT appearance was analyzed.Results Of the 24 cases of AIDS patients with IRIS after HAART,1 9 cases were complicated with pulmonary tuberculosis,which includ-ed 5 cases with cervical tuberculous lymphadenitis,3 cases were co-infected with bacterium and fungi,1 case was infected by penicil-lium marneffei,1 case by pneumocystis carinii.The enlarged thoracic lymphonodus were primarily located in 4R region（20/24）, secondly in 2R region（1 1/24）and 4L region（1 1/24）,in which the density was uniform or non-uniform,edge clear or unclear,some parts of lymphonodus were fused together but not calcified.The minor axis of enlarged lymphonodus was 1 1.0-25.0 mm except X region,enhanced uniformly in 2 cases.Obstructive pneumonia and pulmonary consolidation were found in 2 cases with enlarged lym-phonodus,which were located in 10R region.Pleural effusion was found in 13 cases with greatest depth of about 22 mm,pericardial effusion was found in 5 cases with greatest depth of about 24 mm.Conclusion The enlarged thoracic lymphonodus in AIDS patients with IRIS affer HAART are mainly involved in the region of 4R,2R and 4L,with or without pleural effusion and pericardial effusion.

关 键 词：获得性免疫缺陷综合征 免疫重建炎性综合征 胸部 淋巴结 计算机体层成像 

分 类 号：R512.91[医药卫生—内科学] R814.42[医药卫生—临床医学]