艾滋病合并粟粒性肺结核的CT影像与CD4+T淋巴细胞低下程度的相关分析

doi:10.19871/j.cnki.xfcrbzz.2021.03.017

摘要/Abstract

摘要： 目的分析艾滋病合并粟粒性肺结核的CT影像学表现与其CD4⁺T淋巴细胞低下程度的相关性,为该病的临床诊治提供参考。方法收集苏州市第五人民医院收治的49例艾滋病合并粟粒性肺结核病患者的临床及影像学资料,按其CD4⁺T淋巴细胞计数分为Ⅰ、Ⅱ、Ⅲ组（分别为1~50个/μl、51~100个/μl、101~200个/μl）,分析其CT影像学表现。结果 ①Ⅰ组中粟粒结节的大小、密度、分布表现为“三不均匀”者的发生比例高于Ⅱ、Ⅲ组,差异有统计学意义（P<0.05）。Ⅰ组中斑片状影、胸腔积液、心包积液、纵隔淋巴结肿大以及合并纵隔淋巴结结核和肺外结核的发生率也均高于Ⅱ、Ⅲ组,差异均有统计学意义（P<0.05）。②合并纵隔淋巴结结核病患者中,Ⅰ组的2R、3A区淋巴结及不均匀或分隔强化发生率高于Ⅱ、Ⅲ组,差异均有统计学意义（P<0.05）。③本组随访中3例（6.1%）患者在3个月CT复查时粟粒结节吸收;46例（93.9%）患者粟粒结节吸收时间在6个月以上,且伴有不同程度的新发病灶。结论 CD4⁺T淋巴细胞数目越低,艾滋病合并粟粒性肺结核的CT影像中粟粒结节的大小、密度、分布越不均匀,纵隔淋巴结结核、肺外结核、胸腔积液及心包积液的发生率越高。

关键词: 艾滋病, 结核, 肺, X线计算机, 体层摄影术, CD4⁺T淋巴细胞

Abstract: Objective To analyze the correlation between the CT signs of complicated with miliary tuberculosis and the degree of CD4⁺T lymphocytesreduction, to provide reference for clinical diagnosis and treatment of the disease. Methods Retrospective analysis of CT imaging and clinical characteristics of 49 patients with complicated with miliary tuberculosis admitted to Suzhou Fifth People's Hospital. According to the count of low CD4⁺T lymphocytes, the patients were divided into groups Ⅰ,Ⅱ, and Ⅲ (respectively 1~50, 51~100, 101~200 cells/μl), with the CT imagines analyzed. Results ①The incidence rate of〝three unevenness〞in the size, density and distribution of miliary nodules in groupⅠwas higher than that in groups Ⅱ and Ⅲ, and the difference was statistically significant (P<0.05). The incidence rate of patchy shadow, pleural effusion, pericardial effusion, mediastinal lymphadenopathy, combined mediastinotomy node tuberculosis and extra-pulmonary tuberculosis in group I were also higher than those in group Ⅱ and Ⅲ, and the differences were statistically significant (P<0.05). ②Among mediastinal lymph node tuberculosis patients, the incidence rate of lymph node enlargement at 2 R, 3 A zone and uneven or separated enhancement in groupⅠ was higher than that in groupⅡ, Ⅲ,the difference was statistically significant (P<0.05). ③Miliary nodules of 3 cases (6.1%) had been absorbed during 3 months, and 46 cases (93.9%) absorbed during 6-12 months or more. Most of them accompanied by vary developed lesions. Conclusion The lower the number of CD4⁺T lymphocytes, the size, density, and distribution of miliary nodules in CT images of combined with miliary tuberculosis are more uneven, and the incidence rates of mediastinal lymph node tuberculosis, extra-pulmonary tuberculosis, pleural effusion and pericardial effusion are higher.

Key words: Acquired immune deficiency syndrome, Tuberculosis, Lung, Tomography, Computer tomography, CD4⁺T lymphocytes

任荣, 程晰, 刘荣荣, 袁功玲, 刘静, 姚文妍, 李敏. 艾滋病合并粟粒性肺结核的CT影像与CD4⁺T淋巴细胞低下程度的相关分析[J]. 新发传染病电子杂志, 2021, 6(3): 242-246.

Ren Rong, Cheng Xi, Liu Rongrong, Yuan Gongling, Liu Jing, Yao Wenyan, Li Min. Correlation between CT imaging and the degree of CD4⁺T lymphocyte reduction of complicated with miliary tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(3): 242-246.

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