摘要
目的提高对艾滋病合并肺结核的认识，掌握其临床特征。方法对21例艾滋病合并肺结核患者的临床资料进行分析。结果影像学改变情况：浸润型肺结核18例（85．7％），病变以两肺上叶为主10例（47．6％），两肺下叶为主8例（38．0％）．两肺上、下叶均受累6例（28．5％）。肺门淋巴结肿大10例（47．6％），纵隔淋巴结肿大6例（28．5％）。空洞形成3例（14．2％），多数较小，洞壁较薄。合并胸膜炎2例。粟粒型肺结核5例（23．8％），表现为两肺弥漫性粟粒状结节状影像，病灶直径2～4mm。合并丙肝抗体阳性9例（42．8％），结核菌素（PPD）试验阳性5例（23．8％）。15例（72．4％）抗结核活疗治愈或完成疗程，15例发生抗结核药物不良反应。结论艾滋病合并肺结核常发病急，症状重，PPD试验阳性率低，影像表现常不典型。临床及放射科医师应重视艾滋病流行的现实，对发热伴X线不典型的肺结核患者，应常规检测HIV抗体，提高艾滋病合并肺结核的警惕性。
Objective To improve the knowledge of AIDS complicated with pulmonary tuberculosis and learn its clinical features. Methods The clinical data of 21 patients with AIDS complicated with pulmonary tuberculosis were analyzed. Results Seen From imaging features, infiltrative pulmonary tuberculosis occurred in 18 cases （85.7% ） ,the lesion mainly of the upper lobe of both lungs took place in 10 eases（ 47.6% ） and of the lower lobe in 8 eases（38.0% ） , and both lobes involved in 6 eases（28.5%）. Enlargement of hilar lymph node occurred in 10 cases（47.6%） and swelling of mediastinal lymph node in 6 cases（ 28.5% ）. Cavity was formed in 3 eases（ 14.2% ） , most of which were smaller with the thin wall. Two eases were complicated with pleufitis. Miliary pulmonary tuberculosis in 5 cases（23.8% ） was characterized by diffused military nodular imaging in both lungs,with the diameter of 2-4mm. 5 cases were complicated with positive antibody of Hepatitis C（42.8% ） and positive test of PPD （23.8% ）. 15 cases receiving anti-tuberculosis chemotherapy were cured or completed treatment course and the side effects occurred in 15 cases（72.4% ）. Conclusion AIDS complicated with pulmonary tuberculosis is characterized by the acute occurrence,severe signs,low positive rate of PPD test and atypical manifestation on chest films. Physicians should pay more attention to the prevalence of AIDS and improve the alert to AIDS complicated by pulmonary tuberculosis. Antibody of HIV should be detected for the patients with the atypical X-ray combined with fever.
出处
《中国医药》
2006年第6期323-325,共3页
China Medicine
关键词
艾滋病
结核
AIDS
Tuberculosis
