HIV患者继发卡氏肺囊虫肺炎治疗的胸部CT动态变化  

Dynamic Changes of Thoracic CT in the Treatment of Pneumocystis Carinii Pneumonia in HIV Patients

作　　者：金秋燕 吴金平[1] 焦旭东[1] 杨磊 徐丽娜 恽佳 

机构地区：[1]江苏省常州第三人民医院放射科,213000

出　　处：《临床放射学杂志》2017年第11期1636-1639,共4页Journal of Clinical Radiology

摘　　要：目的探讨人类免疫缺陷病毒(HIV)患者继发卡氏肺囊虫肺炎(PCP)感染治疗的CT影像学表现。方法搜集经临床及病理证实的HIV患者继发PCP 9例,均正规、足量、全程选用复方磺胺甲基异恶唑(SMZ-TMP)治疗,回顾性分析9例患者病程不同时期胸部CT影像表现和治疗的影响。结果 9例胸部CT首次检查表现弥漫性浅淡磨玻璃样影(GGO)2例,GGO伴局限性增粗纹理4例,弥漫性GGO伴弥漫性网状增粗纹理、以及更多融合均匀的肺实变影3例。治疗后3天~8周,GGO完全吸收3例,大部分吸收3例,病灶进展1例,合并其他机遇感染2例,病灶最早有吸收在治疗后第3天。结论 PCP感染主要表现为两肺磨玻璃样改变、网状或斑点状影时,治疗后可完全吸收;两肺弥漫性间质性或实质性均匀阴影,则吸收缓慢,易继发其他感染。Objective To explore the characteristics of chest multi-slice spiral CT and dynamic changes in HIV patients tread for Pneumocystis carinii pneumonia（PCP）. Methods 9 cases with PCP in clinically and pathologically proven AIDS were collected. 9 cases were treated with regular,adequate,complete use of SMZ-TMP drugs. CT manifestations and treatment effects were retrospectively analyzed. Results 9 cases of initial chest CT examination showed diffuse ground glass opacity（GGO） in 2 cases,GGO with localized interstitial thickening in 4 cases,Diffuse GGO with diffuse reticular thickening,as well as more uniform density of 3 cases of pulmonary shadow. During the first 3 days to 8 weeks GGO cleared completely in 3 cases; most of the lesions were absorbed in 3 cases; the lesions progressed in 1case,and the lesions were combined with other opportunistic infections in 2 cases. Conclusion PCP infection manifested as GGO,reticular or nodular shadow,can completely clear after treatment. If the distribution is diffuse interstitial or substantial homogeneous shadows in the lung,treatment results in slow clearance with possibility of secondary infections.

关 键 词：人类免疫缺陷病毒 卡氏肺囊虫肺炎 体层摄影术 X线计算机 

分 类 号：R512.91[医药卫生—内科学] R816.4[医药卫生—临床医学]