艾滋病相关间质型肺孢子菌肺炎HRCT表现与Ⅰ型呼吸衰竭的关系  

Relationship between HRCT findings of AIDS-associated pneumocystis pneumonia and typeⅠrespiratory failure

作　　者：董春娇[1] 杨堉杰 伍彦辉 张淑倩[3] DONG Chunjiao;YANG Yujie;WU Yanhui(Department of Medical Imaging,The Fifth Hospital of Shijiazhuang,Hebei,Shijiazhuang 050021,China;不详)

机构地区：[1]河北省石家庄市第五医院放射科,050021 [2]华北理工大学 [3]河北省人民医院影像科

出　　处：《河北医药》2023年第5期729-732,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展指导计划(编号:181201423)。

摘　　要：目的探讨以间质性病变为主的肺孢子菌肺炎(PJP)的高分辨率CT(HRCT)表现,评估影像表现与Ⅰ型呼吸衰竭的关系,早期指导临床诊疗。方法回顾性分析84例艾滋病合并PJP患者的影像学资料,HRCT以间质性改变为主,总结影像表现;按呼吸衰竭存在与否将PJP分为2组,呼吸衰竭组30例和非呼吸衰竭组54例。比较2组间质病变类型、病变分布范围、伴发影像等。结果间质型PJP以双肺弥漫分布为主,间隔内间质增厚最常见,周围间质增厚次之,中轴间质累及最少。2组比较,间隔内间质及周围间质增厚发生率、磨玻璃影、累及肺段范围、肺气囊及气胸发生率,差异均有统计学意义(P<0.05);其他伴随影像胸腔积液及心包积液,差异无统计学意义(P>0.05)。结论以间质性改变为主的PJP的HRCT表现中,当病变以间隔内间质增厚为主、累及肺段达到18个、出现肺气囊及气胸时,发生Ⅰ型呼吸衰竭几率增加。Objective To investigate the high-resolution computed tomography(HRCT)findings of pneumocystis pneumonia(PCP)with interstitial lesions,and to evaluate its relationship to type I respiratory failure,aiming to provide early guidance for clinical diagnosis and treatment.Methods The imaging data of 84 patients with AIDS-associated PCP whose HRCT findings wer mainly intersititial lesions were retrospectively analyzed to summarize their imaging characteristics.Patients were allocated to two groups according to the presence(n=30)or absence of respiratory failure(n=54).Type of interstitial lesions,lesion distribution and associated imaging characteristics were compared between the two groups.Results Interstitial PCP was mainly distributed in both lungs.Interlobular septal thickening was the most common imaging characteristic,followed by the peripheral stoma thickening,while the axial interstitial thickening was less observed.There were significant differences in the incidences of interlobular septal and peripheral stoma thickening,ground glas opacity,pneumonocele and pneumothorax,and the range of affected pulmonary segments between resipiratory group and non-respiratory group(all P<0.05).There were no significant differences in the incidences of pleural effusion and pericardial effusion between groups(both P>0.05).Conclusion In patients with AIDS-associated PCP whose HRCT findings were mainly intersititial lesions,the main lesion of interlobular septal thickening,involvement of more than 18 segments,and presence of pneumonocele and pneumothorax significantly enhances the incidence of typeⅠrespiratory failure.

关 键 词：艾滋病 肺孢子菌肺炎 高分辨CT Ⅰ型呼吸衰竭 

分 类 号：R512.91[医药卫生—内科学]