Bernasconi A, Zompatori M, Chiodo F, Costigliola P, Ricchi E, Colangeli V, Canini R, Gavelli G
Istituto di Radiologia Università, Policlinico S. Orsola-Malpighi, Bologna.
Radiol Med. 1989 Nov;78(5):461-72.
AIDS (acquired immunodeficiency syndrome) seems to be related to human immunodeficiency virus (HIV) and is characterized by severe T-helpers lymphocyte dysfunction. Many of the AIDS patients (47-70%) develop pulmonary manifestations, both infectious and neoplastic, in the course of their disease. In the Department of Infectious Diseases of our Hospital are studied many patients HIV+. Every year 246 seropositive new patients have been discovered. Among them we have studied 25 subjects with respiratory disease, by chest radiographs; successively, according to clinical picture, we have performed thoracic computed tomography, Gallium scintigraphy, fiberoptic bronchoscopy with transbronchial biopsy (TBB), bronchoalveolar lavage (BAL); the majority of these patients (68%) had AIDS, only 28% had ARC and 4% had PGL. In our experience, the diagnosed diseases were mainly infections (92%), and most frequently (52%) due to Pneumocystis carinii, alone or in association with other etiologic agents. We have not found pathognomonic radiographic abnormalities, but chest X-ray evaluated with clinical and laboratory data, may often be useful to obtain diagnostic indications and in order to determine a more specific and aggressive diagnostic approach.
获得性免疫缺陷综合征(艾滋病)似乎与人类免疫缺陷病毒(HIV)有关,其特征为严重的辅助性T淋巴细胞功能障碍。许多艾滋病患者(47%-70%)在病程中会出现肺部表现,包括感染性和肿瘤性的。我院传染病科对许多HIV阳性患者进行了研究。每年发现246例血清阳性新患者。其中,我们通过胸部X线片对25例患有呼吸系统疾病的患者进行了研究;随后,根据临床表现,我们进行了胸部计算机断层扫描、镓扫描、纤维支气管镜检查及经支气管活检(TBB)、支气管肺泡灌洗(BAL);这些患者中大多数(68%)患有艾滋病,只有28%患有艾滋病相关综合征(ARC),4%患有艾滋病前期淋巴结病综合征(PGL)。根据我们的经验,诊断出的疾病主要是感染(92%),最常见的(52%)是由卡氏肺孢子虫引起的,单独或与其他病原体联合感染。我们未发现具有诊断意义的影像学异常,但结合临床和实验室数据评估的胸部X线片,通常有助于获得诊断线索,并确定更具特异性和积极的诊断方法。