摘要
目的:探讨艾滋病(AIDS)合并粟粒型肺结核的高分辨CT(HRCT)表现与CD4+T细胞水平的关系。方法:对20例经临床证实的AIDS合并粟粒型肺结核的HRCT表现,临床资料以及CD4+T淋巴细胞水平进行回顾性分析,分组资料采用行×列表的χ2检验,P<0.05为差异有统计学意义。结果:粟粒结节影两侧肺野分布11例,一侧肺野分布3例,单侧肺野的某一局部分布6例;分布均匀3例,分布不均17例;大小均匀一致4例,大小不等16例;密度均匀4例,密度不均16例。合并其他影像表现有磨玻璃影7例,肺实变3例,肺门和纵隔淋巴结肿大8例,胸腔积液6例,心包积液2例。粟粒型肺结核分布、大小和密度与CD4+T细胞计数的关系:粟粒型肺结核的发生和分布范围随着CD4+T细胞计数的减少,其发生的可能性越大、累及的范围也越广泛(P<0.05);粟粒结节影的分布、大小和密度随着CD4+T细胞计数下降而表现出明显的不均匀性(P均<0.01)。结论:HRCT能很好地显示AIDS合并粟粒型肺结核的分布、大小、密度等影像特点。CD4+T淋巴细胞水平越低,粟粒型肺结核发生的可能性越大,其分布、大小和密度越不均匀。
Objective：To discuss the correlation between high resolution CT （HRCT） features of AIDS with miliary tuberculosis and CD4＋T cell count. Methods： Combining the clinical data and CD4＋T lymphocyte levels, HRCT performance of 20 cases of AIDS complicated with pulmonary miliary tuberculosis proven clinically were retrospectively analyzed. For packet data we used line X column chi square test,statistical analysis software for spss 13.0. Results： Miliary nodules were found in both lung fields in 11 cases,distribution in one lung field in 3 cases,distribution in one area of unilateral lung field in 6 cases;uniform distribution of miliary nodules in 3 cases, uneven distribution in 17 cases; size of miliary nodules in 4 ca ses, varying in size in 16 cases;miliary nodules of uniform density in 4 cases, uneven density in 16 cases. Combined with other imaging manifestations：ground glass opacity in 7 cases,consolidation of lung in 3 cases, pulmonary hilar and mediastinal lymph nodes enlargement in 8 cases,pleural effusion in 6 cases,and pericardial effusion in 2 cases. Statistical results of mill ary tuberculosis distribution,size and density with CD4＋T cell count. With CD4＋T cell count decreasing, the occurrence possibility of miliary tuberculosis was larger and the involved area was wider,the results were statistically significant （P〈 0.05）;There was a positive correlation between miliary nodules inhomogeneity in the distribution, size, density and the decreasing of CD4＋ T cell count （P〈0.01）. Conclusi6n： HRCT can better display the image characteristics of AIDS associated with miliary tuberculosis in the distribution, size and density. The lower the level of CD4＋T lymphocytes, the larger is the miliary tuberculosis occurrence possibility,and the more inhomogeneous are its distribution,size,and density.
出处
《放射学实践》
2013年第2期150-153,共4页
Radiologic Practice
