Erdozain J C, González García M, Pintado V, Muñoz J F, Castillo P, Presa M, Rodríguez J A, Segura J M
Unidad Ecografía Digestiva, Hospital La Paz, Madrid.
An Med Interna. 1995 Mar;12(3):115-21.
The abdominal manifestations in the patient with HIV infection are increasingly frequent. We have conducted the present study in order to determine the diagnostic usefulness of the abdominal echography in the clinical assessment of the patient.
We review the echographic findings of 112 patients carrying the HIV with or without the Acquired Immunodeficiency Syndrome (AIDS). Seventy eight patients were men and 34, women, with an average age of 30 years. The main risk group was parenterally drug addiction (72%). The stage of the HIV infection was IVC1 in 41% of the cases, II in 23%, III in 13% and IVC2 in 13%. The echographic exploration was performed using a real-time echography, with a probe of 3.5 Mhz, assessing according to conventional criteria the abdominal organs and their pathology, masses and free intraabdominal fluid. The echographic characteristics were first broadly assessed in the patients from the series and later on, according to the patient's pathology. (Infectious, acute abdominal, hepatic biochemical disorders, HIV carrier-associated pathology).
In 33% of the cases, the echography was normal. Hepatomegaly was the most frequent echographic sign: 56 patients (50%), followed by splenomegaly in 43 patients (38.3%), standing out the affection of the biliary and/or vesicular ductus in 7 patients (6.2%). The echographic findings were not related to the HIV infection stage, nor with the presence of hepatic biochemical disorders. However, the presence of organomegaly (hepatosplenomegaly associated or not to retroperitoneal adenopathies) were more frequent in the group with infectious complication, 33.3% vs 19.6% (p < 0.01), that in the patients without associated infectious processes. In patients with medical or surgical acute abdominal pathology, the echography was diagnostic in 9 out of 10 patients.
In the HIV patient, the echography allows an specific initial diagnostic assessment, being able in most of the patients with abdominal manifestations to diagnose the causal pathology.
HIV感染患者的腹部表现日益常见。我们开展本研究以确定腹部超声检查在患者临床评估中的诊断价值。
我们回顾了112例携带HIV病毒的患者的超声检查结果，这些患者有无获得性免疫缺陷综合征（AIDS）。78例为男性，34例为女性，平均年龄30岁。主要风险人群为静脉注射吸毒者（72%）。41%的病例处于HIV感染IVC1期，23%处于II期，13%处于III期，13%处于IVC2期。使用3.5MHz探头的实时超声进行超声检查，根据常规标准评估腹部器官及其病变、肿块和腹腔内游离液体。首先对系列患者的超声特征进行大致评估，随后根据患者的病理情况（感染性、急性腹部疾病、肝脏生化紊乱、HIV携带者相关病理）进行评估。
33%的病例超声检查正常。肝肿大是最常见的超声征象：56例患者（50%），其次是脾肿大43例患者（38.3%），7例患者（6.2%）突出表现为胆管和/或胆囊管受累。超声检查结果与HIV感染阶段无关，也与肝脏生化紊乱的存在无关。然而，伴有感染并发症的组中器官肿大（伴有或不伴有腹膜后淋巴结病的肝脾肿大）更为常见，为33.3%，而无相关感染过程的患者组为19.6%（p<0.01）。在患有内科或外科急性腹部疾病的患者中，10例患者中有9例超声检查具有诊断价值。
对于HIV患者，超声检查可进行特定的初步诊断评估，在大多数有腹部表现的患者中能够诊断出病因病理。
