艾滋病合并肺结核113例临床及CT影像分析  

Analysis of clinical and CT Imaging of 113 AIDS patients with pulmonary tuberculosis

作　　者：柯柳[1] 覃绍超[1] 刘志娟[1] 李俩 佘东明[1] 何唐艳 张月圆 麻芝英 温小凤[1] 袁淑芳 陈念[1] 韦静彬[1] KE Liu;QIN Shaochao;LIU Zhijuan;LI Liang;SHE Dongming;HE Tangyan;ZHANG Yueyuan;MA Zhiying;WEN Xiaofeng;YUAN Shufang;CHEN Nian;WEI Jingbin(Liuzhou People’s Hospital,Liuzhou 545006,Guangxi,China)

机构地区：[1]柳州市人民医院感染性疾病科,广西柳州545006

出　　处：《中国艾滋病性病》2020年第10期1103-1105,共3页Chinese Journal of Aids & STD

基　　金：柳州市科学研究与技术开发计划课题(2015J030519、2016G020210)。

摘　　要：目的分析艾滋病合并肺结核患者的临床特点和X线计算机断层摄影(CT)影像特点。方法对2010年1月至2017年4月本院确诊的艾滋病合并肺结核患者的临床资料及CT征象进行回顾性分析,总结临床特征,比较不同CD4+T淋巴细胞(简称CD4细胞)水平组、痰涂片阳性/阴性组的CT征象及预后。结果113例艾滋病合并肺结核患者平均年龄为(48.06±12.29)岁;CD4细胞≤200个/μL的艾滋病合并肺结核占81.4%;患者临床症状多样,其中发热64例(56.6%),咳嗽58例(51.3%);痰涂片阳性率低(16.8%);胸部影像表现不典型,有多种表现;经积极治疗,获得好转率为79.6%。结论艾滋病合并肺结核的临床表现不典型,CT表现缺乏特点,早期临床医生应该高度重视,尤其对于CD4细胞≤200个/μL者,提高其诊断率,早期积极治疗可改善预后。Objective To analyze the computed tomography(CT)and clinical characteristics of AIDS patients with pulmonary tuberculosis.Methods Retrospective analysis was made based on the clinical data and CT imagine features of the patients diagnosed as AIDS and tuberculosis from January 2010 to April 2017,to summarize the clinical characteristics,and compare the CT imagine characteristics and prognosis of the two groups with different CD4 or different results of sputum smear.Results The average age of the 113 AIDS patients was 48.06±12.29,with 81.4%CD4≤200/μL.The clinical symptoms of the patients included 64 cases with fever(56.6%)and 58 cases with cough(51.3%).The positive rate of sputum smear was low(16.8%).CT imaging was not typical and had various manifestations.After active treatment,a better prognosis could be obtained with the improvement rate of 79.6%.Conclusion The clinical manifestations of AIDS patients with pulmonary tuberculosis are atypical and CT manifestations lack characteristics,which great importance should be attached to,especially the patients with CD4^+≤200/μL,to improve their diagnostic rate and early active treatment.

关 键 词：艾滋病 肺结核 CT诊断 

分 类 号：R512.91[医药卫生—内科学]