艾滋病腹部超声的声像图改变

目的 探讨艾滋病(AIDS)腹部超声的声像图改变特征。方法 50例艾滋病患者应用超声检查，观察肝脏、脾脏、胆囊的超声表现及腹主动脉周围，然后进行分析。结果 AIDS腹部超声的声像图表现为在肝脏、胆囊、脾脏方面均有不同程度的改变及腹腔淋巴结肿大。32例脾脏有不同程度的肿大；37例出现肝脏肿大、肝回声异常；23例出现胆囊壁改变；15例有淋巴结肿大。结论 AIDS患者的肝脏、胆囊、脾脏超声均有不同程度的改变及腹腔淋巴结肿大．其中以肝脏、脾脏改变最为明显，虽然以上声像图改变无明确特异性，但是结合临床病史．可以为临床诊断治疗及分期提供有价值的诊断依据。     

艾滋病患者肝脏病变的彩色多普勒超声表现

目的 探讨艾滋病(AIDS)患者肝脏病变彩色多普勒超声的声像图特征.方法 我院住院的AIDS患者,在接受肝脏彩色多普勒检查中,对其中890例阳性病变的声像图,部分与CT检查、穿刺活检病理、临床观察治疗对照,进行回顾性分析.结果 AIDS患者肝脏病变依次表现为:肝脏肿大、肝脏实质炎症损伤呈局灶性或弥漫性、肝脏钙化灶、肝硬化、肝脓肿、结缔组织部分恶性肿瘤肝侵润形成占位、转移性肝癌、原发性肝癌.以上疾患常在同一患者合并存在.结论 AIDS患者肝脏病变的超声诊断可为临床提供有价值的影像学资料.     

脾结核超声表现1例

患者女，29岁。1年前出现发热，咳嗽，无痰，右颈部淋巴结肿大到某医院就诊，结核菌素试验（ ），胸部CT显示；双肺野散在多发结节，小点状阴影，中上肺野明显，纵隔淋巴结肿大，肝，脾CT显示，肝脾肿大，腹腔淋巴结肿大，颈部淋巴结针吸病理结果，炎性改变。临床考虑：Ⅱ型肺结核，淋巴结结     

艾滋病超声表现1例

患者男 ,3 0岁。因反复畏寒、高热 40余天 ,经多家医院诊治无效而来我院就诊。 1个月前曾有右颈部淋巴结肿大。查体 :体温 40 .5℃ ,双侧腹股沟触及数个大小不等的肿大淋巴结 ,肝、脾未触及 ,心率 12 0次 /min ,律齐 ,左胸骨旁第 4肋间可闻及响亮高调吹风样杂音。血尿培养均未见细菌生长 ,结核抗体及肥达氏反应阴性。胸部X线检查 :两肺未见病变 ,右上纵隔及肺门淋巴结肿大。超声检查 :肝实质回声均匀 ,右肝内测及一团状强回声 ,1.4cm× 0 .8cm ,后方伴声影 ,胆囊大小为 6.7cm× 2 .3cm ,囊腔内见 0 .6cm× 0 .4cm ,0 .7cm× 0 .6cm的团状强…     

艾滋病伴发腹部结核的超声表现

目的 探讨艾滋病伴发腹部结核的超声表现特征.方法 回顾性分析88例艾滋病伴发腹部结核患者超声资料.结果 88例艾滋病伴发腹部结核患者中,超声表现为腹部淋巴结肿大者66例（75.00%）,其中31例伴发颈部淋巴结肿大,18例表现为分叶状融合团块,其内可见大片细小点状回声漂浮的无回声区;肝脏结核47例（53.41%）,其中肝肿大40例,肝实质局灶性病变13例,表现为大小、分布较均匀的高或低回声结节;脾脏结核49例（10.63%）,脾肿大41例,脾实质病变15例,其中局灶性病变14例,表现为多发均匀低回声小结节,弥漫性病变1例,呈＂虫蚀样＂改变;肠结核8例（9.09%）;胰腺结核2例（2.27%）;沁尿系统结核2例（2.27%）;腹水14例（15.91%）.结论 艾滋病伴发腹部结核超声表现与病理相符,病变内未见钙化出现,容易形成大面积液化;多个脏器同时受累多见,淋巴结、肝、脾是最常受累的部位.     

超声诊断胎儿先天性心脏病合并浆膜腔积液1例

患者女 ,2 8岁 ,孕 30周 ,孕 1产 0 ,无不适表现。产科检查未见异常。孕早期曾患流感 ,无用药史。申请超声检查。超声所见 :胎儿腹腔及胸腔内测及不规则无回声区 ,前心包腔内测及厚约 4.0ｍｍ无回声区。心脏彩色超声 :收缩期右心房内测及源于三尖瓣口反流血流 ,流速为 3.0 8ｍ/ｓ ,右心房明显增大 ,内径 17.5ｍｍ ,三尖瓣前叶及后叶位置明显下移 ,室间隔肌部缺损 ,直径约 8.0ｍｍ ;ＣＤＦＩ示双向血流信号。超声诊断 :①胎儿心脏发育异常 ,三尖瓣下移畸形 ,室间隔缺损 ;②胎儿浆膜腔积液 ,中量胸腹水 ,少量心包积液。后终止妊娠 ,引产出一女…     

颈淋巴结结核的超声表现与分型

目的探讨超声检查颈淋巴结结核的超声表现及分型。方法对180例经病理证实的颈淋巴结结核超声表现进行回顾分析,包括病灶部位、数量、形态、内部回声及血流分布等声像图特征,结合淋巴结结核病理学表现进行临床分型。结果将颈淋巴结结核分四型：急性炎症型、干酪坏死型、寒性脓肿型、愈合钙化型,超声表现对疾病的诊断、预后及疗效评价具有较大,临床意义。结论颈淋巴结结核因就诊时间及病程不同．而具有不同的声像图特征,超声可作为首选的影像学检查方法.     

流行性腮腺炎的超声表现分析

流行性腮腺炎(epidemic parotitis mumps)是临床常见病,以发热、腮腺肿大为典型症状[1],本研究对147例流行性腮腺炎的超声特征进行回顾性分析,总结如下。一、资料与方法1.对象:选取2009年4月至2011年4月以面部肿痛、发热2～3d就诊,经我     

艾滋病(AIDS)患者合并丙型肝炎的腹部超声表现分析

目的分析艾滋病合并丙型肝炎患者的腹部超声表现,以供临床参考。方法以2010年8月～2012年7月在我院接受治疗的艾滋病合并丙型肝炎患者45例为研究对象,回顾性分析其临床资料,观察腹部超声表现。结果所有患者腹部超声检查均提示肝实质回声致密增粗,占100.00%;其中伴有肝肿大8例,占17.78%;均有脾实质回声致密增粗,占100.00%;其中伴有脾肿大18例,占40.00%;伴有胆囊壁增粗26例,占57.78%;呈双圈表现5例,占11.11%。结论艾滋病合并丙型肝炎患者的肝脏、脾脏、胆囊等脏器的超声检查均提示不同程度的改变,腹部超声检查可提供有价值的诊断依据。     

超声引导下穿刺活检对获得性免疫缺陷综合征患者合并淋巴结肿大的病因诊断价值

目的： 经超声引导下穿刺活检分析获得性免疫缺陷综合征（acquired immunodeficiency syndrome，AIDS）患者合并淋巴结肿大的病因。方法： 对2017年4月至2020年12月在上海市公共卫生临床中心行超声引导下穿刺活检的130例AIDS合并淋巴结肿大患者的病理诊断及实验室指标等进行回顾性分析，进而分析超声引导下穿刺活检对该类患者淋巴结肿大病因的诊断价值。结果： 130例患者中，最终诊断良性病变82例（63.1%），包括淋巴结核56例，非结核分枝杆菌感染7例，马尔尼菲篮状菌感染6例，坏死性淋巴结炎5例，隐球菌感染2例，巨细胞病毒感染2例，金黄色葡萄球菌感染、淋巴组织增生、淋巴囊肿、EB病毒感染各1例；恶性肿瘤36例（27.7%），包括淋巴瘤17例（其中弥漫大B细胞淋巴瘤、Burkitt淋巴瘤各5例，浆母细胞淋巴瘤、小淋巴细胞性淋巴瘤及间变大细胞淋巴瘤各1例，另4例未分型），转移性肿瘤17例，卡波西肉瘤2例；病因类型不明确12例，其中病理检查提示11例为良性病变、1例为肿瘤性坏死。130例患者淋巴结肿大病因总诊断率达90.8%。所有患者无并发症。结论： 超声引导下穿刺活检对AIDS合并淋巴结肿大患者淋巴结肿大病因诊断率高，且微创安全，对于该类患者淋巴结肿大临床早期诊断及精准治疗具有较高价值，值得临床推广应用。     

Focal esophageal candidiasis in acquired immunodeficiency syndrome (AIDS)

When candidiasis involves the esophagus, it usually does so as an extensive and diffuse infection. In our experience, however, esophageal candidiasis in patients with the acquired immunodeficiency syndrome (AIDS) is clinically distinct from the same infection in patients with other immunodeficiency states. Of 25 patients with AIDS and esophageal candidiasis studied radiographically, 4 patients with localized involvement of the esophagus are presented. The clinical and radiologic manifestations of focal esophageal candidiasis in these patients are reviewed and compared to previously described cases of esophageal candidiasis.     

Septic shock in patients with the acquired immunodeficiency syndrome

Objective: To evaluate the prognosis of patients with septic shock admitted to an intensive care unit (ICU), according to their HIV serostatus. Design: Retrospective study. Setting: Medical ICU of a university hospital. Patients: 76 patients with septic shock admitted to the same ICU, of whom 28 were HIV positive and 48 were HIV negative. Measurements and results: Severity scores, number and type of organ failures, and survival rates were assessed in the two groups of patients. Glasgow Coma Scale and general severity scores [Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score (SAPS)] were significantly worse in HIV-infected patients. The total number of organ failures was also higher in the HIV-positive group: 3.7 ± 0.2 vs 3.1 ± 0.2 in the HIV-negative group (p < 0.001). On day 28, 21 (46 %) HIV-negative patients were dead compared to 26 (93 %) patients in the HIV-positive group (p < 0.001). In the multivariate analysis, HIV infection was an independent risk factor for mortality, as were the SAPS score, use of mechanical ventilation, and the McCabe score. Conclusions: This study reports a considerable excess mortality in HIV-infected patients with septic shock. Although severity of illness was clearly much more pronounced in HIV-positive patients, retroviral infection was independently associated with death. Improving survival in HIV-positive patients with septic shock may require earlier diagnosis and treatment of the causative infection. Received: 30 September 1996 Accepted: 8 July 1997     

Paraproteinemia in patients with acquired immunodeficiency syndrome (AIDS) or lymphadenopathy syndrome (LAS)

Eight of 15 patients with acquired immunodeficiency syndrome (AIDS) and six of nine patients with lymphadenopathy syndrome (LAS) had paraproteins in their sera. Twelve of these 14 were IgG kappa; the other two had no demonstrable light chains. The relationship of the paraprotein to the pathogenesis of AIDS is not clear, but we discuss its relation to derangements of B-cell immune regulation and function and to B-cell tumors in AIDS patients.     

Evaluation of patients with the acquired immunodeficiency syndrome (AIDS) by fiberoptic bronchoscopy

Hospital records were reviewed on 78 consecutive patients (33 homosexuals, 37 Haitians and 8 IV drug abusers) who had AIDS and who underwent fiberoptic bronchoscopy over a two year period. Pneumocystis carinii pneumonia (PCP) was the most common bronchoscopic finding (53.8% of patients) followed by tuberculosis (14.1%), cytomegalovirus infection (12.8%) and atypical mycobacteriosis (3.8%). In 15.4% of patients multiple organisms were found. Twenty-seven percent of patients had non-diagnostic bronchoscopies. In 8 patients with non-diagnostic bronchoscopies, open-lung biopsy or autopsy revealed PCP (2 patients), Kaposi's sarcoma (3 patients) and non-specific lymphocytic-plasmacytic infiltrates (3 patients). Histologic studies of transbronchial biopsy specimens were more sensitive for the diagnosis of PCP than touch imprints. PCP was diagnosed in 15 patients who had received trimethoprim-sulfamethoxazole for up to 4 days. Mean duration of respiratory symptoms prior to bronchoscopy was 4.2 weeks in patients with PCP and was not significantly different in patients with other bronchoscopic diagnoses. Historical, laboratory and chest radiographic parameters were not helpful in establishing a diagnosis or assessing prognosis in these AIDS patients with pulmonary infiltrates. Fiberoptic bronchoscopy with transbronchial biopsy is safe (only one of the patients had a self limited hemorrhagic episode) and sensitive for the diagnosis of pulmonary infiltrates in patients with AIDS.     

The role of cytokines in the acquired immunodeficiency syndrome

Summary HIV replication in vitro is regulated by many factors, including various exogeneous stimuli and proteins encoded by either virus or cellular genomes. During the asymptomatic period, cells latently or chronically infected with HIV gradually express virus, leading to immunosuppression and opportunistic infection. These conditions would result in the increased secretion of cytokines, especially TNF, from infected and uninfected cells, which can induce HIV and killing of infected cells. A vicious circle is then set in motion in which heterologous microbial infections directly or indirectly activate HIV and the production of cytokines, thereby accelerating lymphocyte depletion and immunodeficiency. AIDS is a disorder of the immune network caused by a unique retrovirus HIV. However, if the whole story described above is true, this disease can also be termed a “cytokine disease”. Immunity resembles a “doubleedged sword”, with aspects not only protective, but also deleterious to the host. Therefore, it is essential to more extensively investigate the mechanism of cytokine regulation of HIV expression in vivo, not only to understand the complex patohophysiology of AIDS, but also to design a therapeutic strategy to halt this deadly disease.     

The role of ultrasonography in the detection of extrapulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS)

Three cases of extrapulmonary tuberculosis are presented. Retroperitoneal and periportal adenopathy were the major manifestation of the disease detected by ultrasonography in all three cases. All of the patients were subsequently diagnosed as having acquired immunodeficiency syndrome (AIDS). The lymphohematogenous dissemination of the disease and the diagnostic role of ultrasonography are discussed.     

Diagnostic imaging of the brain in acquired immunodeficiency syndrome (AIDS)

The central nervous system is commonly involved in acquired immunodeficiency syndrome (AIDS), resulting in a variety of lesions and diseases. They can be divided into the primary effects of human immunodeficiency virus (HIV), opportunistic infections, tumors, and vascular disease. This article is a review of the major imaging findings observed in each disease, with clinical and pathological correlations relevant to the goal of differential diagnosis.     

Idiopathic esophageal ulceration in the acquired immunodeficiency syndrome: Radiologic reappraisal in 10 patients

Idiopathic esophageal ulceration in patients with AIDS has previously been described. Establishing this diagnosis is important because of the excellent response of these ulcers to corticosteroid therapy. We studied 10 such patients with esophagography and endoscopy. HIV was isolated from the ulcer base in six of the 10 patients utilizing various techniques including in situ hybridization. No other organisms were found. All of the ulcers were in the distal half of the esophagus and were solitary in eight of the 10 patients. The solitary ulcers were large (2.5×2.0 cm to 12×9 cm) and deep (>0.5 cm) with undermined margins. In three patients, fistulae arose from the distal esophagus and crossed the gastroesophageal junction. In one patient, a huge idiopathic ulcer perforated into the mediastinum. These latter findings are not seen in the more common ulcerating AIDS esophagitides due to herpes simplex and cytomegalovirus.