摘要
目的探讨艾滋病合并肺结核患儿的临床和影像学表现特征。方法回顾性分析确诊的38例艾滋病合并肺结核患儿的临床资料和影像学表现。结果 38例患儿中,全部为母婴传播;临床表现均有发育迟缓及不同程度营养不良,常伴发热(23例)、咳嗽(22例)、气促(9例)、腹泻(8例)、皮疹(6例)、呕吐(4例)、头痛嗜睡(3例)等症状;合并马尔尼菲青霉病7例(18.42%,7/38),肺孢子菌肺炎5例(13.16%,5/38)。影像学表现:位于两肺野25例(65.79%,25/38),上叶和(或)下叶背段6例(15.79%,6/38),右中叶1例(2.63%,1/38),一侧肺下叶基底段2例(5.26%,2/38),两侧肺下叶基底段4例(10.53%,4/38)。形态主要表现为斑片状22例(57.89%,22/38),大片状6例(15.79%,6/38),磨玻璃样4例(10.53%,4/38),结节状5例(13.16%,5/38),条索状1例(2.63%,1/38),伴空洞2例(5.26%,2/38),胸内外淋巴结肿大25例(65.79%,25/38),少量胸腔积液7例(18.42%,7/38),少量心包积液2例(5.26%,2/38)。随访中,治愈或好转27例(71.05%,27/38),其中3例曾发生免疫重建炎性综合征;未治愈5例(13.16%,5/38),死亡6例(15.79%,6/38)。结论儿童艾滋病合并肺结核临床表现多样,缺乏特异性;影像学检查对诊断本病,明确肺内病灶分布、形态、胸内淋巴结肿大及胸腔积液等具有一定价值,可为临床诊断提供重要依据。
Objective To explore characteristics of clinical and imaging manifestations of children with AIDS complicated with pulmonary tuberculosis. Methods The retrospective analysis of clinical data and imaging manifestations of 38 children with AIDS complicated with confirmed pulmonary tuberculosis was conducted. Results All of the 38 children suffered from the disease through mother-to-child transmission （MTCT） （100.00%,38/38）, with clinical manifestations of growth retardation and malnutrition with different degrees usually accompanied by fever（23）, cough（22）, dyspnea（9）, diarrhea（8）, skin rash（6）, emesis（4）, headache and somnolence（3） etc. Moreover, there were 7 cases of AIDS complicated with penicillium marneffei （PM） （18.42%,7/38） and 5 cases of AIDS complicated with pneumocystis carinii pneumonia （13.16%,5/38）. Imaging manifestations were as follows： there were 25 children with lesions located in two lung fields （65.79%,25/38）, 6 children with lesions in dorsal segment of upper lobe and （or） lower lobe （15.79%,6/38）, 1 child with lesions in right middle lobe （2.63%,1/38）, 2 children with lesions in basal segment of lower lobe lung （5.26%,2/38） and 4 children with lesions in basal segment of lower lobe of bilateral lung （10.53%,4/38）. The morphological features were mainly displayed as follows： 22 cases of patch （57.89%,22/38） and 6 cases of large patch （15.79%,6/38）, 4 cases of ground glass opacity （10.53%,4/38）, 5 cases of nodule （13.16%,5/38）, 1 case of streak form （2.63%,1/38）, 2 cases complicated with cavity formation （5.26%,2/38）, 25 cases of intrathoracic and extrathoracic lymphadenectasis （65.79%,25/38）, 7 cases of little pleural effusion （18.42%,7/38）, 2 cases of little pericardial effusion （5.26%,2/38）. In the follow-up, 27 children took a change for the better （71.05%,27/38）, where 3 children once suffered from immune reconstitution inflammatory syndrome （IRIS）, 5 children were not
出处
《中国防痨杂志》
CAS
2013年第12期1013-1019,共7页
Chinese Journal of Antituberculosis
基金
广西壮族自治区卫生厅自筹经费项目(Z2013685)
关键词
结核
肺
放射摄影术
获得性免疫缺陷综合征
放射摄影术
胸部
儿童
Tuberculosis, pulmonary/radiography
Acquired immunodeficiency syndrome
Radiography,thoracic
Child
