艾滋病合并肺结核的CT表现与CD4T淋巴细胞的关系

目的:探讨艾滋病合并肺结核的CT表现与CD4T淋巴细胞的关系。材料和方法:回顾性分析临床确诊的23例艾滋病合并肺结核CT扫描资料,并定期CT复查以及CD4T淋巴细胞的检测,观察其HARRT及抗结核治疗后肺部病灶的动态变化。结果:病灶分布两个肺叶以上10例、中叶(舌叶)及下叶17例。大片状融合实变影9例、斑片状影6例、双肺弥漫性结节影5例和空洞影2例。纵隔及肺门淋巴结肿大15例,主要分布2R、4R区。病灶恶化进展患12例,CD4T淋巴细胞持续降低或衰竭;病灶吸收或缩小11例,早期CD4不同程度降低,3个月后CD4均有不同程度升高。结论:CT扫描能有效显示病变的各种征象,有利于艾滋病合并肺结核的诊断。CD4T淋巴细胞的量值是影响肺结核病变的动态变化及预后的重要因素。

The Correlation between CT Appearances and CD4 T Lymphocytes in AIDS Pulmonary Tuberculosis

Purpose:To study the correlation between CT features and CD4 T lymphocytes in AIDS pulmonary tuberculosis.Materials and Methods:The CT features of 23 patients with AIDS pulmonary tuberculosis were analyzed retrospectively and CD4 T lymphocytes were measured regularly,at subsequently intervals.all of patients were received multidrug antiretroviral and antituberculous therapy.Results:The lesions located in two or more lobes in 10 cases,in middle lobe,lingular lobe,or two inferior lobes in 17cases.CT appearances of pulmonary tuberculosis including larger confluent consolidation in 9 cases,patch consolidation in 6 cases,nodular opacities widely distributed in the lung fields in 5cases,and cavities shadow in 2 cases.Fifteen cases had hilar or mediastinal lymphadenopathies.The enlarged lymph nodes were mostly located in region 2R and 4R regions.Conclusions:CT scan effectively shows a great variety of imaging signs of pulmonary tuberculosis in AIDS and is helpful to clinical diagnosis.The count of CD4 T lymphocytes is a vital factor,which influences the radiological change and prognosis of pulmonary tuberculosis.