艾滋病患者合并重症肺结核的X线表现的探讨

Discussion on Radiograph Findings in Patients with AIDS Combined with Severe Tuberculosis

目的:分析监狱医院艾滋病患者合并重症肺结核的X线表现特点。材料与方法:回顾性分析40例我监狱医院艾滋病感染重症肺结核患者X线表现特点,全部患者均在抗结核前及抗结核后1月、3月行X线胸正、侧位片检查。结果:本组40例患者中,治疗前病变同时累及两肺33例,占82.5%,其中右肺35例,左肺33例,全部病例病灶分布≥3个肺野,渗出灶34例,占85%;坏死灶26例,占65%;空洞形成31例,占77.5%。治疗3个月后胸片显示,病灶同时累及两肺25例,占62.5%,其中右肺27例,左肺24例,34例病灶分布≥3个肺野。渗出灶21例,占50.25%;坏死灶18例,占45%;空洞25例,占62.5%;病灶增多恶化6例,占15%。结论:艾滋病感染重症肺结核其X线表现具有病灶分布广,多性质病灶共存,渗出灶、坏死灶及空洞多见,病灶易增多恶化的特征。

Purpose： To analyze the radiograph findings in patients with AIDS combined with severe tuberculosis from the prison hospital. Materials and Methods： The radiograph findings in 40 cases of patients with AIDS combined with severe tuberculosis from the prison hospital were reviewed retrospectively. Anterior and lateral chest radiographic views were both conducted on all patients in respectively 1 and 3 months before and after antituberculous treatment. Results： Among the 40 cases, 33 cases of lesions occurred in both lungs before treatment, accounting for 82. 5% ; 35 cases of lesions occurred in the right lung and 33cases in the left lung. All the lesions were distributed in more than 3 lung fields. There were 34 cases of exudation lesions, 26 cases of necrotic lesions and 31 cases of cavitation, accounting for 85% , 65 % and 77. 5 %, respectively. The chest radiograph after 3 months of treatment showed that 25 cases of lesions （ accounting for 62. 5% ） occurred in both lungs, 27 cases occurred in the right lung and 24 cases in the left lung. A total of 34 cases of lesions were distributed in more than 3 lung fields. There were 21 cases of exudation lesions, 18 cases of necrotic lesions and 25 cases of cavitation, account- ing for 50. 25%, 45% and 62. 5%, respectively. Lesions increased in 6 cases which are 15% of all the cases. Conclusion： The features of the radiograph findings in patients with AIDS combined with severe tuberculosis were wide distribution of lesions, coexistence of multi - natured lesions, presences of exudation lesions, necrotic lesions and cavities, and increasing of lesions.