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[HIV阳性患者肺结核的影像学表现]

[The radiological pictures of pulmonary tuberculosis in HIV+ patients].

作者信息

Cornalba G, Damiani G, Mariani P, Dedivitis G, Orlando G, Cargnel A

机构信息

Servizio di Radiodiagnostica, Ospedale L. Sacco, Milano.

出版信息

Radiol Med. 1991 Nov;82(5):609-12.

PMID:1780458
Abstract

Mycobacterial infections can be found in 10% of AIDS patients. Seventy cases with HIV+ infection were examined: they exhibited clear alterations of the chest and contemporaneous isolation and identification of mycobacteria. Primary tuberculosis is the most frequent manifestation in these patients. Alveolar parenchymal mono/bilateral infiltrates are the radiographic patterns of this pulmonary condition; they usually present without excavation (45.7%). Hilar and/or mediastinal lymph nodes are usually associated, and no pleural effusions. The main problem is the differential diagnosis with pneumocystis carinii pneumonia, especially the form involving lung apices. A correlation has been observed between the blood level of T-lymphocytes and their subsets (CD4 level) and the radiographic patterns of tuberculosis in AIDS patients. In fact, pleural effusion is frequent in patients with CD4 less than 200, while miliary nodules and cavitations are more frequent in the cases with CD4 greater than 200.

摘要

10%的艾滋病患者会出现分枝杆菌感染。对70例HIV阳性感染者进行了检查:他们表现出明显的胸部病变,同时分离并鉴定出了分枝杆菌。原发性肺结核是这些患者最常见的表现。肺泡实质单/双侧浸润是这种肺部疾病的影像学表现;通常无空洞形成(45.7%)。肺门和/或纵隔淋巴结通常受累,无胸腔积液。主要问题是与卡氏肺孢子虫肺炎进行鉴别诊断,尤其是累及肺尖的类型。在艾滋病患者中,观察到T淋巴细胞及其亚群的血液水平(CD4水平)与肺结核的影像学表现之间存在相关性。事实上,CD4低于200的患者胸腔积液很常见,而CD4高于200的患者粟粒结节和空洞更常见。

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