30例免疫低下与肺结核

目的：分析免疫低下患合并肺结核的临床特点。方法：对我科1995－2001年收治的免疫低下合并肺结核病的30例患进行回顾性分析，结果：（1）与服用糖皮质激素及其他免疫抑制剂有关。（2）易延误诊断。（3）愈后差，死亡率高，结论：对免疫低下的患尤其是长期应用糖皮质激素，要注意肺结核的发生，提高早期确诊率。     

免疫功能低下患者肺结核的影像诊断

目的探讨几种免疫功能低下疾病并发肺结核患者的X线和CT所见。包括糖尿病、肾病综合症、系统性红斑狼疮（SLE）和获得性免疫缺陷综合症（AIDS）合并肺结核。方法回顾分析合并肺结核糖尿病患者68例，肾病综合症患者20例．SLE患者12例，AIDS患者8例X线及胸部CT所见。结果X线和CT表现，糖尿病合并肺结核：大片浸润病灶45例．浸润病灶内多发空洞40例，散在大小不等浸润病灶可不按肺段分布23例，支气管播散病灶21例；部分病例合并胸水10例。肾病综合症或SLE：急性血行播散性肺结核15例，大小不等浸润病灶17例，合并肺门及纵膈淋巴结肿大4例；AIDS合并肺结核；肺内斑片阴影合并有淋巴结肿大5例，急性血行播散性肺结核合并有淋巴结肿大3例。结论免疫功能低下疾病并发肺结核时，肺内结核病灶容易形成大片干酪病灶并合并空洞，结核肺内播散，急性血行播散性肺结核，肺门及纵膈淋巴结肿大及非结核好发部位发生浸润结核灶。     

老年人细菌性肺炎免疫功能改变研究进展

老年人细菌性肺炎的发生,发展与机体免疫功能紊乱有关,具体表现在体液免疫过亢,补体系统过度激活;细胞免疫状态明显低下,T细胞免疫调节网络平衡失调,明显干扰了细胞内外信息传递功能和免疫应答功能,抗感染免疫功能低下,炎性细胞因子过度分泌造成机体的严重损伤,从而导致复杂而严重的临床症状,临床疗效不佳。     

免疫功能低下时的寄生虫感染

免疫功能低下时的寄生虫感染许炽纪爱萍随着器官移植的广泛开展和大量免疫抑制剂的应用，以及艾滋病患者的日愈增多，一些机会性寄生虫，特别是某些原虫感染也相应增多，且病情常明显加重。人类免疫缺陷病毒（ＨＩＶ）对淋巴细胞表面上能表达ＣＤ４分子的Ｔ辅助细胞有选...     

老年与青年肺结核患者免疫功能差异的探讨

目的：探索老年肺结核患者与青年肺结核患者细胞免疫和体液免疫的各自特点以及两者的差异和相关免疫指标的临床意义。方法检测175例老年肺结核患者（老年组）和151例中青年肺结核患者（中青年组）免疫功能,并与50例健康人群（健康组）进行比较分析。采用流式细胞术（ FCM）检测肺结核患者和健康人群外周血CD3＋T细胞、CD4＋T细胞、CD8＋T细胞、NK细胞、B细胞比率;采用免疫透射比浊法测定免疫球蛋白水平。结果老年组CD3＋、CD4＋细胞与中青年组和健康组比较明显降低,差异有统计学意义（ P＜0?01）。中青年组CD4＋、CD8＋T细胞比率明显高于健康组,差异有统计学意义（ P＜0?01）。 NK细胞老年组最高、健康组次之、中青年组最低,3组间差异均有统计学意义（ P＜0?01）。老年和中青年肺结核患者血清IgA均高于健康组,差异有统计学意义（ P＜0?01）。结论中青年肺结核患者免疫功能明显高于健康人群,免疫效应细胞以CD4＋、CD8＋T细胞为主。老年肺结核患者的细胞免疫功能明显低于健康人群,免疫效应细胞以NK细胞为主。青年肺结核患者与老年肺结核患者在体液免疫功能方面无明显差异。     

慢支咳喘灵对免疫低下小鼠免疫功能的影响

目的 探讨慢支咳喘灵对免疫低下小鼠免疫功能的影响。方法 制备免疫低下功能模型小鼠，给予慢支咳喘灵，14天后进行免疫功能的测定。结果 中、高剂量的慢支咳喘灵应用后均可使免疫功能低下小鼠的体重、胸腺和脾脏重量显著增加（P〈0．05或P〈0．01），但小剂量组作用不甚明显。与模型组比较，慢支咳喘灵中、高剂量具有显著促进吞噬作用（P〈0．05或P〈0．01）；高剂量时的吞噬作用和正常对照组差异无显著性（P〉0．05），但小剂量组作用不甚明显；高、中、低3个剂量组的慢支咳喘灵对小鼠迟发型变态反应均有显著的抑制作用（P〈0．05或P〈0．01），可显著提高血清溶血素水平（P〈0．05或P〈0．01）。结论 慢支咳喘灵可提高机体的免疫功能。     

免疫功能低下宿主巨细胞病毒肺炎

巨细胞病毒是引起免疫功能低下宿主肺部感染最常见的病原之一,在临床上起病急、进展快,如不能及时诊断和干预,往往会在短期內发展为急性肺损伤甚或急性呼吸窘迫综合征及多器官功能衰竭,病死率高,预后差.实验室病毒学检测对早期诊断具有重要作用.在治疗上除了对症支持、保证氧合外,早期应用更昔洛韦抗病毒联合静脉丙种球蛋白,在一定程度上可改善预后,降低病死率.除非有明确细菌感染的指征或有创呼吸治疗,一般不主张给予联合抗生素治疗,以避免治疗进一步复杂化.     

肺结核患者T淋巴细胞亚群,红细胞免疫功能与核仁组成区 …

目的 探讨结核病患者Ｔ淋巴细胞亚群，红细胞免疫功能及核仁组成相关嗜银蛋白（ＡｇＮＯＲｓ）的关系及其临床意义。方法 采用碱性磷酸酶抗碱性磷酸酶（ＡＰＡＡＰ）法，红细胞花环试验以及ＡｇＮＯＲｓ测定方法，对５９例肺结核患者和５０名正常对照组分别测定了外周血Ｔ淋巴细胞亚群，红细胞免疫Ｃ３ｂ受体花环率（Ｅ－Ｃ３ｂＲＲ）与红细胞循环免疫复合物花环率（Ｅ－ＩＣＲ），ＡｇＮＯＲｓ面积（ＧＡ），核面积（ＮＡ）及ＧＡ     

老年肺癌患者免疫功能的研究

近年来对肺癌的免疫功能研究颇受重视 ,但大多研究仅限于某个细胞功能。为此我们选择了外周血 T淋巴细胞亚群、自然杀伤细胞 (NKC)活性和淋巴细胞转化率作为免疫指标 ,综合研究了 134例老年肺癌患者的细胞免疫功能 ,以期为肺癌的免疫治疗提供理论依据。1　对象与方法1.1　 对象　老年肺癌组 134例 ,初诊确诊为原发性肺癌。男112例 ,女 2 2年 ,年龄 6 0～ 80岁 ,平均 76 .8岁 ,均经细胞学或病理学证实。未采用任何治疗方法 ,排除免疫方面的疾病。鳞癌99例 ,腺癌 12例 ,小细胞癌 17例 ,大细胞癌 6例。非老年肺癌组 112例 ,男 87例 ,女 2 5例…     

Pulmonary tuberculosis in the HIV-positive patients

Tuberculosis associated with human immunodeficiency virus (HIV) infection continues to represent a serious medical and public health problem. Physicians' awareness of this entity is important because the diagnosis requires a high index of suspicion. A continuing increase in the cases of tuberculosis associated with HIV infection is predicted unless extensive efforts are directed toward detection of this dual infection and implementation of effective tuberculosis preventive therapy and treatment programs.     

重视老年肺血管病研究

肺血管疾病是临床常见的严重危害人类健康的疾病。老年人由于病理生理特点,发生肺血管疾病时临床特征、治疗决策以及预后具有特殊性。探索老年肺血管病的早期诊断及有效的诊治方案,对改善预后具有临床意义。     

Pulmonary and cardiac functions in patients with pulmonary tuberculosis

Four hundred and nineteen elderly and old patients with pulmonary tuberculosis were examined. One hundred and ninety six patients were found to have an active tuberculous process and contaminant diseases: essential hypertension in 20.7%, functional classes II-III angina pectoris in 55.6%, postinfarct cardiosclerosis in 23.7%. Hypertrophy of the right cardiac cavities was frequently accompanied with that of the left ones (38.1%). Respiratory diseases caused by comorbidity were prevalent among acid-alkali balance disorders. Metabolic disturbances were detected in 90 (21%) patients. Evaluation of pulmonary and cardiac functions by the analysis of acid-alkali balance, gases, blood, and ECG in geriatric patients allows pathogenetic therapy to be timely and soundly.     

Pulmonary tuberculosis in patients with diabetes mellitus.

BACKGROUND: Diabetes mellitus has been reported to modify the presenting features of pulmonary tuberculosis, but there are varying data, particularly regarding the association with lower lung field involvement. OBJECTIVES: To determine whether diabetes mellitus alters the clinical and radiographic manifestations of tuberculosis in nonimmunocompromised hosts and to define the determinants of lower lung field involvement. METHODS: A retrospective review of the records of all patients with tuberculosis and diabetes mellitus seen during a 14-year period and of an age- and sex-matched nondiabetic control group with tuberculosis was carried out. The duration of symptoms, tuberculin reaction, bacteriologic and radiographic findings of the two groups were compared. RESULTS: The presence of diabetes mellitus was found not to have an effect on patients' symptomatology, bacteriology results, tuberculin reaction and localization of pulmonary infiltrates. On the other hand, fewer diabetic patients were smear-positive and fewer had reticulonodular opacities compared with the control patients. A higher number of insulin-dependent diabetic patients presented with cavitary disease as compared with nondiabetic controls. Lower lung field tuberculosis was significantly associated with female gender and, in patients older than 40 years, was more frequently observed in diabetics. CONCLUSION: These data show that diabetes does not affect the presenting features of pulmonary tuberculosis to a large extent and is only associated with lower lung field disease in older patients.     

Pulmonary tuberculosis in patients with acquired immunodeficiency syndrome

An association between tuberculosis and HIV infection is becoming increasingly evident. HIV seropositivity has been seen in nearly 30% of some populations with tuberculosis. In other populations nearly 25% of patients with AIDS had tuberculosis. Clinically these patients present with nonspecific findings including weight loss, night sweats, and fever. The symptoms are generally gradual in onset and last for several weeks. Early in the course of HIV infection a PPD skin test may be positive and the radiographic findings may be similar to those seen in individuals with normal immunity. Thus, upper lobe heterogeneous and cavitary opacities may be seen on the chest radiograph. In late HIV infection, however, the PPD skin test is generally negative and the radiograph demonstrates lymphadenopathy and diffuse heterogeneous parenchymal opacities. Tuberculosis should be suspected in HIV-infected patients when diffuse interstitial lung disease is demonstrated in conjunction with hilar or mediastinal lymph node enlargement. In contrast, lymphadenopathy is not expected in the most common opportunistic lung disease, Pneumocystis carinii pneumonia. Standard antituberculous drug therapy is extremely effective in treating tuberculosis in this setting.