HIV/AIDS合并肺结核的CT表现与肺功能相关性初步研究

Preliminary Research:Correlation between the Appearances of CT in HIV/AIDS Patients Complicated with Tuberrulosis and Pulmonary Function

目的研究HIV/AIDS合并肺结核患者不同CT成像与肺功能检查(PFT)相关性.方法收集60例HIV/AIDS合并肺结核患者的全部CT资料及肺功能测定结果,与同期住院的30例无肺结核的HIV/AIDS患者和30例单纯肺结核患者设为对照组.定量分析肺内病变程度范围并进行评分,与肺功能指标做相关性分析.结果 60例患者肺结核CT表现为空洞2例、下肺斑片结节26例、胸膜病变5例、间质病变12例、混合病变15例.单纯HIV/AIDS组的各项肺功能指标明显优于HIV/AIDS合并肺结核组和单纯肺结核组,比较有统计学意义(P<0.01).空洞、斑片结节和混合病变对应的肺功能损伤较重.CT评分结果与肺功能测定呈负相关.结论结核感染的不同程度肺功能损伤与CT影像存在相关性.两者相结合有助于提高HIV/AIDS合并结核诊断率,肺功能检查可作为HIV/AIDS合并肺结核感染的辅助诊断手段.

Objective To study CT appearances of HIV/AIDS patients complicated with tuberrulosis and the correlation with pulmonary function testing.Methods 60 HIV/AIDS patients complicated with tuberrulosis were selected in experimental group,30 HIV/AIDS patients without tuberrulosis and 30 tuberrulosis patients without HIV/AIDS were selected in control group.Their CT data and results of the pulmonary function test were collected.CT appearances of pulmonary parenchymal abnormalities including distribution and extent of involvement were quantitatively analyzed and scored.The correlation of CT scores with the results of pulmonary function tests was analyzed statistically.Results Of the CT features in these 60 patients,there were cavitation（n=2,3.33%）nodular lesions and patchy changes in low lobes of lungs（n=26,43.3%）,interstitial lung disease（n=12,20%）,pleural effusion and pleural thickening（n=5,8.33%）,and mixed disease（n=15,25%）.The pulmonary function index of 30 HIV/AIDS patients without tuberrulosis were obviously higher than that of 60 HIV/AIDS patients complicated with tuberrulosis and 30 tuberrulosis patients without HIV/AIDS,there were significant differences（P0.01）.When CT appeared cavitation,nodular lesions and patchy changes,and mixed disease,the pulmonary function of patients showed a more remarkable impairment.CT score had a negative correlation with pulmonary function tests.Conlusions There is significant correlation between CT findings and pulmonary function test results in tuberrulosis.CT combined with pulmonary function test can inmprove the diagnosis rate of HIV/AIDS patients complicated with tuberrulosis.Pulmonary function could be a new auxiliary diagnosis methods in HIV/AIDS patients complicated with tuberrulosis.