CT应用于获得性免疫缺陷综合征伴肺结核感染患者的诊断价值及影像学表现  

Value of CT in diagnosis of acquired immunodeficiency syndrome patients complicated with pulmonary tuberculosis and imaging manifestations

作　　者：华奇峰[1] 胡爱荣[2] 张叶娜[3] 郑建军[1] 孙微[1] 陈国平[1] 张宏彬[1] 胡碧波[1] 金银华[1] 

机构地区：[1]宁波市第二医院放射科,浙江宁波315000 [2]宁波市第二医院肝病感染科,浙江宁波315000 [3]宁波市第二医院肺科,浙江宁波315000

出　　处：《中华医院感染学杂志》2017年第10期2241-2244,共4页Chinese Journal of Nosocomiology

基　　金：浙江省区域专病中心建设学科基金资助项目(2014-98)

摘　　要：目的探讨CT用于获得性免疫缺陷综合征伴肺结核感染患者的诊断价值,为临床诊治提供参考。方法选取2010年1月-2015年2月医院收治的60例获得性免疫缺陷综合征伴肺结核患者为观察组;另选取同期60例正常免疫伴肺结核患者为对照组;统计两组患者手术组织病理学及实验室检查结果、临床表现及预后情况;分析两组患者病变类型和分布及范围;比较两组患者CT表现。结果观察组患者发热、呼吸困难、乏力、纳差、体重下降、浅表淋巴结肿大、头痛、腹泻、视物模糊、口腔黏膜白斑、皮肤瘙痒、皮疹、尿频、尿痛、尿急、伴其他肺部感染、肺外结核等发生率均明显高于对照组,差异有统计学意义(P<0.05);观察组患者病变多位于中下肺,而对照组多位于上肺,观察组患者病变范围分布于3叶以上者明显多于对照组,而局限于1叶肺者明显少于对照组,Ⅰ、Ⅱ、Ⅳ及Ⅴ型者明显多于对照组,差异有统计学意义(P<0.05);观察组CT征象钙化、空洞和纤维化及支气管扩张率明显低于对照组,而纵隔淋巴结肿大和粟粒结节及胸腔积液率明显高于对照组(P<0.05)。结论获得性免疫缺陷综合征患者临床症状较多,且其肺内病灶主要位于其中下肺,并累及3叶及以下;但当采用CT检查提示患者出现淋巴结肿大或胸腔积液或粟粒结节征象时,则需考虑患者发生肺结核,从而可实施针对性诊治,为改善其预后提供帮助。OBJECTIVE To explore the value of CT in diagnosis of acquired immunodeficiency syndrome patients complicated with pulmonary tuberculosis so as to provide guidance for clinical diagnosis and treatment.METHODS Totally 60 acquired immunodeficiency syndrome patients complicated with pulmonary tuberculosis who were treated in the hospital from Jan 2010 to Feb 2015 were chosen as the observation group,meanwhile,60 normal immune patients complicated with pulmonary diseases were set as the control group.The results of surgical histopathology and laboratory examination,clinical manifestations,and outcomes were statistically analyzed;the types,distribution,and range of lesions were observed;the CT manifestations were compared between the two groups of patients.RESULTS The incidence rate of fever,dyspnea,fatigue,poor appetite,weight loss,superficial lymph node enlargement,headaches,diarrhea,blurred vision,white spot of the oral mucosa,skin itching,skin rash,frequent urination,dysuria,urgent urination,complication with other pulmonary infections,or extrapulmonary tuberculosis was significantly higher in the observation group than in the control group （P〈0.05）.Most of the lesions located in the middle and lower lungs of the patients in the observation group and in the upper lungs of the patients in the control group.The patients with the lesions ranged more than 3 lobes of the observation group were significantly more than those of the control group,however,the patients with the lesions restricted in 1 lobe were significantly less than those of the control group;the patients of the type Ⅰ,Ⅱ,Ⅳ,or Ⅴ were significantly more in the observation group than in the control group（P〈0.05）.The rates of the CT signs such as calcification,hollow,fibrosis,and bronchiectasis were remarkably lower in the observation group than in the control group,however,the rates of mediastinal lymph node enlargement,millet nodules,and pleural effusion were significantly higher in the observation group than in the control group （P〈0

关 键 词：获得性免疫缺陷综合征 肺结核 CT 影像学 诊断 

分 类 号：R521[医药卫生—内科学]