摘要
目的探讨艾滋病（AIDS）并发结核患者在高效抗逆转录病毒治疗（HAART）中发生免疫重建炎性综合征（IRIS）的临床特征及影像表现。方法回顾分析4例AIDS并发结核患者在HAART中发生IRIS的临床及影像资料。结果临床见发热4例，乏力及体重减轻3例，腹痛2例，咳嗽、咯痰1例，胸闷、喘憋1例。CT及MRI见颈部和（或）锁骨上区淋巴结增大3例，腹股沟淋巴结增大1例，肺门或纵隔淋巴结增大2例，腹部淋巴结增大1例；肝及肺实质受侵2例，肾、肾上腺、肠系膜、腹膜、腰大肌、脑及皮肤软组织受累1例。以上临床及影像表现均具有临时性及白限性特征，随着抗结核及HAART联合治疗的继续，病情均出现好转。结论AIDS并发结核患者在HAART中均有可能发生IRIS，影像检查对IRIS的早期诊断、病情监测、疗效评价及治疗具有重要的作用。
Objective To explore the clinical characteristics and radiological manifestations of immune reconstitution inflammatory syndrome （IRIS） in acquired immunodefieiency syndrome （ AIDS ） patients with tuberculosis （TB） during highly active antiretroviral therapy （HAART）. Methods The clinical and radiological data in 4 AIDS patients with TB who presented IRIS were analyzed retrospectively. Remits The clinical presentations of IRIS in 4 patients included fever （4 eases）, weakness and weight loss （3 cases）, abdominal pain （2 eases） ,cough with sputum （1 ease） ,dyspnea （1 ease）. Cervical and （or） supra-clavicular lymph node enlargement were seen in 3 patients, inguinal lymph node enlargement in 1 patient, abdominal lymph node enlargement in 1 patient, hilar or mediastinal lymph node enlargement in 2 patients, pulmonary parenehyma and liver were involved in 2 patients, the involvement of kidney, adrenal gland, mesentery, peritoneum, psoas, brain and eutis was respectively found in 1 patient. The clinical and radiological presentations of IRIS were temporary and self-limited, improvement can be seen with antituberculosis therapy and HAART. Conclusions It is possible to have IRIS during HAART in AIDS patients with TB. Imaging examinations play an important role in the early diagnosis, monitoring and evaluating the response to therapy of IRIS.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第2期149-151,共3页
Chinese Journal of Radiology
关键词
获得性免疫缺陷综合征
结核
磁共振成像
体层摄影术
X线计算机
Acquired immunodeficiency syndrome
Tuberculosis
Magnetic resonance imaging
Tomography, X-ray computed
