艾滋病合并肺结核的CT表现多样性与CD4^+T淋巴细胞计数的关系

Varieties of CT Manifestations of Pulmonary Tuberculosis in AIDS Patients and Correlation with CD4^+T Lymphocyte Count

目的:探索艾滋病合并肺结核的CT表现特点及其发病与CD4+T淋巴细胞水平的关系。方法:对经病原体检查或病理证实的44例艾滋病合并结核的CT片和临床资料及CD4+T淋巴细胞水平进行回顾分析。结果:粟粒性肺结核15例,结节状15例,磨玻璃状6例,纤维索条状5例,斑片状、絮状16例,空洞5例,肿块5例,胸膜增厚2例,胸水11例,钙化1例,淋巴结肿大16例,病灶位于肺门周围,或上叶前段、下叶基底段和中叶或舌叶。肺结核分型、累及肺段数目,胸内淋巴结肿大,结核性空洞形成等均与CD4+T淋巴细胞水平有密切关系。结论:CT可显示肺结核的各种征象,CD4+T淋巴细胞水平决定肺结核表现的多样性与转归。

Objective：To study the CT manifestations in AIDS patients complicated with pulmonary tuberculosis（PTB） and correlation with pathogenesis and CD4＋T lymphocyte counts.Methods：The clinical materials,CD4＋T lymphocyte count and CT manifestations of 44 AIDS patients proved by etiology or pathology and complicated with PTB were retrospectively analyzed.Results：Of the CT features in these 44 patients,there were miliary tuberculosis（n=15,34.0%）;nodular lesions（n=15,34.0%）;ground-glass opacities（n=6,13.6%）;stripe-like fibrous changes（n=5,11.4%）;patchy changes（n=16,36%）;cavitation（n=5,11.4%）;mass（n=5,11.4%）;pleural thickening（n=2,5.4%）,pleural effusion（n=11,25.0%）,calcification（n=1,2.7%） and lymphadenopathy（n=16,36.4%）.Lesions located adjacent to pulmonary hila,basal segments of lower lobes,middle lobe or lingual lobes.Classification of tuberculosis,number of pulmonary lobe involved,intra-thoracic lymphadenopathy,cavitation were in close relationship with CD4＋ lymphocyte counts.Conclusion：Various features of PTB could be assessed on CT imaging,the PTB features and its prognosis were depended on CD4^＋ lymphocyte count.