摘要
目的探讨艾滋病合并耐多药肺结核与非艾滋病合并耐多药肺结核胸部CT表现特征,并进行对比分析,为临床诊断及治疗提供依据。方法收集2014年12月至2019年4月南宁市第四人民医院确诊艾滋病合并耐多药肺结核25例作为观察组,非艾滋病合并耐多药肺结核50例作为对照组,对比分析艾滋病与非艾滋病合并耐多药肺结核的胸部CT表现。结果两组在肺野分布方面均以两肺全肺野分布为主,观察组15例(15/25,60.0%),对照组33例(33/50,占66.0%),差异无统计学意义(P>0.05);在病灶形态学上,观察组粟粒状影、磨玻璃影发生率较对照组高,结节状影、斑片状影、斑点状影、条索影、干酪性肺炎/毁损肺、钙化灶、空洞发生率较对照组低,差异均有统计学意义(P<0.05);在合并肺外表现上,观察组心包积液、纵隔/肺门淋巴结肿大、合并其他部位结核发生率较对照组高,而肺门纵隔/淋巴结钙化、胸膜增厚发生率较对照组低,差异均具有统计学意义(P<0.05);在胸腔积液上两组差异无统计学意义(P<0.05)。结论艾滋病合并耐多药肺结核的胸部CT影像学表现为病灶分布范围广,多累及全肺野。在病灶形态学上,其磨玻璃影、粟粒结节为其与非艾滋病耐多药肺结核相区别的特征性改变,且更容易合并纵隔/肺门淋巴结肿大、心包增厚/心包积液及胸腔积液。
Objective To investigate the CT features of multi-drug resistant tuberculosis(MDRTB)in AIDS patients and in non-AIDS patients.and conduct comparative analysis to provide evidence for its clinical diagnosis and treatment.Method From December 2014 to April 2019,25 cases of AIDS complicated with MDR-TB diagnosed in the Fourth People's Hospital of Nanning were collected as the observation group,and 50 cases of non AIDS patients with MDR-TB as the control group.Comparative analysis in CT manifestations of AIDS with MDR-TB and non-AIDS patients with MDR-TB were performed.Results In terms of lung field distribution,lesions in both of these two groups were mainly distributed in the whole lung of the two lungs with no statistically significant difference between two groups(15/25 vs 33/50,P>0.05).Regarding lesion morphology,the incidences of miliary and ground glass appearance in the observation group were significantly higher than those in the control group,while the incidences of nodular,patchy,spotty,streak appearance,caseous pneumonia/lung damage,calcification and cavity were significantly lower in the observation group than those in the control group(P<0.05).As for extrapulmonary manifestations,the incidence of pericardial effusion,mediastinal/hilar lymph node enlargement and tuberculosis in other parts of the body in the observation group was significantly higher than that of the control group,while the incidence of hilar mediastinal/lymph node calcification and pleural thickening was significantly lower than that of the control group(P<0.05),There was no significant difference in the occurrence of pleural effusion between the two groups(P<0.05).Conclusion The CT imaging findings of AIDS complicated with MDR-TB showed that the lesions had a wide range of distribution and usually involved the whole lung field.In terms of the morphology of the lesions,the ground glass appearance and the grainy appearance were the most characteristic changes of the lesions that were different from those of non-AIDS MDR-TB,and were more likely to be associated with mediastinal/hilar lymph node enlargement,pericardial thickening/pericardial effusion and pleural effusion.
作者
黎瑜
刘夏
周静如
邹俊
卢亦波
Li Yu;Liu Xia;Zhou Jingru;Zou Jun;Lu Yibo(Department of Radiology,the Fourth People's Hospital of Nanning,Guangxi AIDS Clinical Treatment Center,Infectious Disease Hospital affiliated to Guangxi Medical University,Nanning 530023,China;Department of Infectious Disease,the Fourth People's Hospital of Nanning,Guangxi AIDS Clinical Treatment Center,Infectious Disease Hospital affiliated to Guangxi Medical University,Nanning 530023,China)
出处
《新发传染病电子杂志》
2021年第1期27-30,共4页
Electronic Journal of Emerging Infectious Diseases
基金
“十三五”国家科技重大专项(2018ZX10302104-001)
广西壮族自治区中药管局自筹经费科研课题(Z20180855)
南宁市兴宁区科学研究与技术开发项目(2018A06)。
关键词
艾滋病
耐多药结核
体层摄影术
X线计算机
Acquired immune deficiency syndrome
Multidrug resistant tuberculosis
Tomography,X-ray computed
