不同CT表现的HIV阴性患者肺部隐球菌感染的临床特征  

Clinical Characteristics of Pulmonary Cryptococcal Infection in HIV-Negative Patients with Different CT Findings

作　　者：廖庆华 董云旭[2] 黄珊珊 梁安棋 王嘉雯 陈亮 LIAO Qing-hua;DONG Yun-xu;HUANG Shan-shan;LIANG An-qi;WANG Jia-wen;CHEN Liang(Guangdong Center for tuberculosis Control,Guangzhou 510630,Guangdong Province,China;Department of Radiology,the third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,Guangdong Province,China;Department of Science and Education,Guangdong Center for tuberculosis Control,Guangzhou 510630,Guangdong Province,China;Department of Epidemiological Surveillance,Guangdong Center for tuberculosis Control,Guangzhou 510630,Guangdong Province,China)

机构地区：[1]广东省结核病控制中心,广东广州510630 [2]中山大学附属第三医院放射科,广东广州510630 [3]广东省结核病控制中心科教科,广东广州510630 [4]广东省结核病控制中心流行病学监测室,广东广州510630

出　　处：《中国CT和MRI杂志》2022年第5期110-112,122,共4页Chinese Journal of CT and MRI

基　　金：国家科技重大专项基金(2018ZX10715004-002)。

摘　　要：目的 分析不同CT表现的HIV阴性患者肺部隐球菌感染的临床特征。方法 回顾性分析32例HIV阴性患者肺隐球菌感染患者资料。根据结节是否伴有磨玻璃影(GGO)/实变影,将患者分为两组,比较两组的临床特征。结果 32例HIV阴性肺隐球菌感染患者有10例(31.3%)GGO,4例(12.5%)实变影,4例(12.5%)GGO及实变影。单发及多发结节分别为8例(25.0%)、24例(75.0%)。14例结节不伴有GGO/实变影,18例结节伴有GGO/实变影。18例结节伴有GGO/实变影患者的血红蛋白(12.0[8.9~16.5]vs 8.4[4.4~14.9])和血小板(24.6[10.2~36.0] vs8.4[1.4~30.3])明显低于14例不伴有GGO/实变影患者的血红蛋白和血小板(分别为P=0.0 4 4和P=0.023)。两组患者的性别、年龄、体重指数、初诊症状、糖化血红蛋白、白细胞、淋巴细胞、白蛋白、血沉、C反应蛋白、免疫球蛋白的差异无统计学意义。结论 肺结节伴有GGO/实变影的HIV阴性隐球菌感染患者的血红蛋白和血小板低于肺结节不伴有GGO/实变影的HIV阴性隐球菌感染患者。Objective To analyze clinical characteristics of pulmonary cryptococcal infection in HIV-negative patients with different CT findings. Methods Medical records of 32 HIV-negative patients with pulmonary cryptococcosis diagnosed at our institution were retrospectively analyzed. CT examinations were obtained with a multidetector row CT scanner. The clinical characteristics of 14 patients with nodules without ground-glass opacity(GGO)/consolidation type were compared with those of 18 patients with inclusive GGO or consolidation type. Results 10(31.3%) cases of GGO, 4(12.5%) cases of solid shadows, and 4(12.5%) cases of GGO and solid shadows were seen in 32 HIV negative patients with pulmonary cryptococcus infection. 8(25.0%) patients with single nodule and 24(75.0%) patients with multiple nodules were showed. There were 14 patients without GGO/consolidation, and 18 patients with GGO/consolidation. Most lesions were located in the lower lobes. The levels of hemoglobin[12.0(8.9~16.5) vs 8.4(4.4~14.9)] and platelets [24.6(10.2~36.0) vs 8.4(1.4~30.3)] were significantly lower in patients with inclusive GGO or consolidation type compared with those of patients without GGO or consolidation(P=0.044 and P=0.023, respectively). There was no statistically significant difference in sex, age, body mass index, symptoms at initial consultation, HbA1c, WBC, lymphocytes,albumin, ESR, CRP, and IgG. Conclusion The levels of hemoglobin and platelets were lower in patients with GGO or consolidation compared with those of patients without GGO or consolidation.

关 键 词：肺 体层摄影术 X线计算机 感染 

分 类 号：R563[医药卫生—呼吸系统] R445.3[医药卫生—内科学]