Wang E E, Read S E, Zuliani J, Blanchette V S
Pediatr Infect Dis J. 1987 Apr;6(4):383-7. doi: 10.1097/00006454-198704000-00008.
Lymphadenopathy is an important component of a wide variety of different illnesses including the acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related conditions. In this study two pairs of observers independently examined the lymph nodes of hemophiliacs younger than 18 years of age to determine the level of agreement of assessments of lymph node mass (the product of the number and mean diameter of lymph nodes). Spearman correlation coefficients for the first and second pairs of observers were 0.75 (P less than 0.001) and 0.66 (P less than 0.005), respectively. The range of lymph node mass was quite different for controls (2.8 to 3.8), human immunodeficiency virus I (HIV)-seronegative hemophiliacs (4 to 5.7) and HIV-seropositive hemophiliacs (10.3 to 15.6). The HIV serologic status could be predicted by lymph node mass. In this group of hemophiliacs, if the lymph node mass was less than 5 cm, the probability of being HIV-seropositive was 0.14. The corresponding probabilities if the lymph node mass was in the range 5 to 9.99, 10 to 14.99, 15 to 19.99 and 20 or greater were 0.33, 0.8, 0.67 and 1.00, respectively. Thus there is adequate agreement between observers in assessing the lymph node mass and there is a direct relationship between lymph node mass and evidence of infection with HIV.
淋巴结病是包括获得性免疫缺陷综合征及与获得性免疫缺陷综合征相关疾病在内的多种不同疾病的重要组成部分。在本研究中，两组观察者独立检查了18岁以下血友病患者的淋巴结，以确定对淋巴结肿块评估（淋巴结数量与平均直径的乘积）的一致程度。第一组和第二组观察者的斯皮尔曼相关系数分别为0.75（P<0.001）和0.66（P<0.005）。对照组（2.8至3.8）、人类免疫缺陷病毒I（HIV）血清学阴性的血友病患者（4至5.7）和HIV血清学阳性的血友病患者（10.3至15.6）的淋巴结肿块范围差异很大。HIV血清学状态可通过淋巴结肿块来预测。在这组血友病患者中，如果淋巴结肿块小于5cm，HIV血清学阳性的概率为0.14。如果淋巴结肿块在5至9.99、10至14.99、15至19.99以及20或更大范围内，相应的概率分别为0.33、0.8、0.67和1.00。因此，观察者在评估淋巴结肿块方面有足够的一致性，并且淋巴结肿块与HIV感染证据之间存在直接关系。
