艾滋病合并肺结核病患者的影像分析

目的对艾滋病（AIDS）合并肺结核病患者进行影像学分析，为认识和诊断AIDS合并肺结核提供依据。方法回顾分析2008年1月一2011年1月21例确诊AIDS合并肺结核患者（观察组）的临床及影像学资料，并与30例单纯肺结核患者（对照组）对比。结果21例AIDS合并肺结核中17例累及2个或以上肺段，14例影像学表现为磨玻璃影，7例伴弥漫粟粒性病灶，8伴肺门和（或）纵隔淋巴结肿大，5例伴有肺外结核；而30例单纯肺结核中，20例仅累及1个肺段，21例影像表现为实变影或斑片影，20例伴有纤维增殖灶，16例有1个或多个空洞；以上影像学特征发生率两组差异有统计学意义。两组胸腔积液发生率差异无统计学意义。结论AIDS合并肺结核与单纯肺结核在影像学表现上有明显差别，且具有一定影像学特征，主要表现多种性质的病灶共存、多形态、多叶、段分布，了解其相关临床影像表现特征有利于AIDS并发肺结核的早期诊断和治疗。

Imaging Analysis on Acquired Immunodeficiency Syndrome Combined with Pulmonary Tuberculosis

Objective To carry out imaging analysis in 21 cases of acquired immunodeficiency syndrome(AIDS) combined with pulmonary tuberculosis(PTB),in order to provide a basis for recognizing and diagnosing the disease.Methods The clinical and imaging data of 21 cases of AIDS merged with PTB from January 2008 to January 2011 were analyzed retrospectively,and were compared with those of 30 patients with pure PTB.Results In the 21 AIDS patients with PTB,the lesions occurred in 2 or more than 2 pulmonary segments in 17,and the main chest radiological findings included ground-glass opacities in l4 patients,accompanied by widespread phlyctenule lesions in 7,hilar or/and mediastinal lymphadenopathy in 8 and extra-pulmonary tuberculosis in 5.However,in the 30 patients with pure PTB,20 had their lesions in only one pulmonary segment,and the imaging findings appeared as opacities or patches shadow in 21,accompanied with fibrillous proliferation lesion in 20 and one or more than one cavitation in 16.Significant difference was found between the patients with pure PTB and the AIDS patients with PTB in imaging features,while no statistical difference was detected in the occurrence of pleural effusion.Conclusions The imaging findings of patients with PTB and AIDS are significantly different compared with the patients with pure PTB.For PTB in the AIDS patients,various imaging,multi-morphological lesions and multi-segments are common.Understanding the relevant clinical imaging features can help clinicians in early diagnosis and management of the AIDS patients with PTB.