艾滋病合并肺结核与单纯肺结核临床特征及胸部CT差异性研究  

Clinical Characteristics and Difference of CHEST CT between HIV-associated Pulmonary Tuberculosis and Pure Pulmonary Tuberculosis

作　　者：莫胜林[1] 黄小红 覃锦玉 陈涛[1] 蒙达礼[1] 胡家光[1] 张鹏[1] 李敏基[1] 邹博 蒋忠胜[1] MO Sheng-lin;HUANG Xiao-hong;QIN Jin-yu;CHEN Tao;MENG Da-li;HU Jia-guang;ZHANG Peng;LI Min-ji;ZOU bo;JIANG Zhong-sheng(The Second Ward of Infectious Diseases Department,Liuzhou People's Hospital,Liuzhou 545006,Guangxi Province,China)

机构地区：[1]柳州市人民医院感染性疾病科二病区,广西柳州545006

出　　处：《中国CT和MRI杂志》2021年第4期64-67,共4页Chinese Journal of CT and MRI

基　　金：“十三五”国家科技重大专项课题(2018ZX10302104-001);广西医药卫生课题(Z20180304、Z 20180286);柳州市人民医院院内基金立项课题(LRY201905、LRY201715);柳州市科技计划项目(2019BJ20601)。

摘　　要：目的分析比较艾滋病合并肺结核与单纯肺结核的临床特征及胸部CT影像学表现的差异性。方法将我院200例肺结核患者作为研究对象,其中艾滋病合并肺结核患者100例,单纯肺结核患者100例,收集其临床资料,包括临床特征、实验室检查、胸部CT影像学表现。结果艾滋病合并肺结核患者胸痛、发热、纳差、贫血、低蛋白血症、真菌感染比例均高于单纯肺结核患者(P<0.05);艾滋病合并肺结核PPD试验阳性率、抗酸杆菌涂片阳性率均低于单纯肺结核患者(P<0.05);艾滋病合并肺结核患者CT表现中粟粒性阴影、磨玻璃密度影、斑片或大片实变影、纵膈淋巴结增大比例、胸膜增厚、纵隔淋巴结增大比例高于单纯肺结核患者(P<0.05),空洞样病变、钙化比例、增殖性病灶比例、支气管壁增厚比例均低于单纯肺结核患者(P<0.05)。结论艾滋病合并肺结核与单纯肺结核患者临床特征及胸部CT表现均存在一定差异,临床医师需结合患者临床特征和胸部CT检查情况,同时结合CD4^(+)T淋巴细胞计数水平,以提高疾病诊治效能。Objective To analyze and compare the clinical features and chest CT manifestations of AIDS combined with pulmonary tuberculosis and pure pulmonary tuberculosis.Methods 200 patients with pulmonary tuberculosis in our hospital were selected as research objects,including 100 patients with AIDS combined with pulmonary tuberculosis and 100 patients with simple pulmonary tuberculosis.Clinical data were collected,including clinical manifestations,laboratory examination,and chest CT manifestations.Results The proportion of chest pain,fever,poor appetite,anemia,hypoproteinemia,and fungal infection in AIDS patients with tuberculosis was higher than that in patients with tuberculosis alone(P<0.05).The positive rates of PPD test and acid-fast bacilli smear were lower than those of patients with simple tuberculosis(P<0.05).AIDS tuberculosis patients CT manifestations of shadow,ground glass density of su li sex and patch or consolidation of the large proportion of shadow,increase of mediastinal lymph nodes,pleural thickening,mediastinal lymph node enlargement ratio is higher than pure tuberculosis patients(P<0.05),empty sample lesion,calcification proportion,the proportion of hyperplastic lesions,bronchial wall thickening percentage are lower than pure tuberculosis patients(P<0.05).Conclusion There a re some diffe rences in the clinical characteristics and chest CT manifestations of PATIENTS with AIDS combined with tuberculosis and tuberculosis alone.Physicians should combine the clinical cha racteristics of patients with chest CT examinations and THE CD4^(+)T lymphocyte count level to improve the diagnosis and treatment effect of the disease.

关 键 词：艾滋病合并肺结核 单纯肺结核 临床特征 电子计算机断层扫描 

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