艾滋病合并肺结核的CT征象及其与CD4^+T淋巴细胞计数的关系

Correlation between CT manifestations and CD4^+T lymphocytes counts in patients with AIDS complicating pulmonary tuberculosis

目的探讨艾滋病(AIDS)合并肺结核的CT征象及其与CD4+T淋巴细胞计数的相关性。方法回顾性分析临床确诊的42例AIDS合并肺结核患者CT扫描资料以及流式细胞仪对CD4+T淋巴细胞的检测结果,分析CT征象与CD4+T淋巴细胞计数的关系。结果本组典型肺结核13例(30.95%),CD4+T淋巴细胞计数(143.15±64.28)个/μl;不典型肺结核29例(69.05%),CD4+T淋巴细胞计数(72.53±26.55)个/μl,两者比较差异有统计学意义(P<0.05)。随着CD4+T淋巴细胞数目的下降,右肺中叶及双肺下叶病变发生率明显增加(P<0.05);CT征象表现为斑片实变影、多发结节影、多发空洞形成、并发淋巴结肿大,与CD4+T淋巴细胞数目呈负相关(P<0.05),单发空洞形成与CD4+T淋巴细胞数目呈正相关(P<0.05)。结论AIDS合并肺结核患者的CT征象多不典型,这与CD4+T淋巴细胞计数明显降低有关。

Objective To explore the CT manifestations of patients with acquired immunodeficiency syndrome （ AIDS） com-plicating pulmonary tuberculosis （ PTB） and the correlation between image findings and CD 4＋T lymphocytes counts .Methods The CT manifestations of 42 patients with AIDS complicating PTB were analyzed retrospectively .Blood CD4＋T lymphocytes were measured by a flow cytometry.The correlation between CT manifestations and CD 4＋T lymphocytes counts was analyzed .Results The CD4＋T lympho-cytes counts of 13 patients with typical tuberculosis were （143.15 ±64.28 ）/μl while CD4＋T lymphocytes counts of 29 patients with a-typical tuberculosis were（72.53 ±26.55）/μl.The difference was statistically significant （P 〈0.05）.As the number of CD4＋T lym-phocytes decreased ,the middle of the right lung and double incidence of pulmonary lower lobe lesions significantly increased （ P 〈0.05）.The incidence of the patching or large consolidation shadows ,multiple nodules,multiple cavity formation,and lymph node en-largement was correlated with CD 4＋T lymphocyte count level （ P〈0.05 ） .The incidence of the single cavity formation had a positive correlation with CD4＋T lymphocyte count level （ P 〈0.05 ） .Conclusion The CT manifestations of patients with AIDS complicating PTB are mostly of the atypical pattern ,and related to a significant decrease in CD 4＋T lymphocytes counts .