N'Dhatz M, Domoua K, Coulibaly G, Traore F, Kanga K, Konan J B, Beugre L K, Doulhourou C, Yapi A
Service de Pneumophtisiologie, CHU de Treichville, Abidjan, Côte d'Ivoire.
Rev Pneumol Clin. 1994;50(6):317-22.
The aim of this prospective study was to investigate the main features of standard chest X-ray in patients with concomitant tuberculosis and HIV infection. From 21 December 1992 to 21 February 1993, we compared 45 chest X-rays of HIV+patients with pulmonary tuberculosis with those of 73 HIV negative patients with pulmonary tuberculosis. Our results revealed that extrapulmonary thoracic localizations were remarkably frequent in HIV+tuberculosis patients (57.8% versus 22% in HIV-patients; P < 0.05). Extrapulmonary localizations were frequently mediastinal lymph nodes (82.7%). Parenchymal involvement was often extensive including frequent miliary images (20% versus 38.3% in HIV-patients). Thus despite the lack of CD4 counts in our study, we were able to observe that about one half the co-infected tuberculosis patients had reached the stage of AIDS as defined by the CDC in 1987. These findings are in agreement with those reported in the literature and would suggest that thoracic manifestations of tuberculosis is a good marker of the state of immunodepression.
这项前瞻性研究的目的是调查合并肺结核和HIV感染患者的标准胸部X光的主要特征。从1992年12月21日至1993年2月21日，我们将45例合并肺结核的HIV阳性患者的胸部X光片与73例肺结核HIV阴性患者的胸部X光片进行了比较。我们的结果显示，肺外胸部定位在HIV阳性肺结核患者中极为常见（57.8%，而HIV阴性患者为22%；P<0.05）。肺外定位常见于纵隔淋巴结（82.7%）。实质受累往往广泛，包括频繁出现粟粒样影像（2%，而HIV阴性患者为38.3%）。因此，尽管我们的研究中没有CD4细胞计数，但我们能够观察到，约一半的合并感染肺结核患者已达到1987年美国疾病控制与预防中心（CDC）定义的艾滋病阶段。这些发现与文献报道一致，表明肺结核的胸部表现是免疫抑制状态的良好指标。
