不同CT表现的HIV阴性患者肺部隐球菌感染的临床特征

Clinical Characteristics of Pulmonary Cryptococcal Infection in HIV-Negative Patients with Different CT Findings

目的 分析不同CT表现的HIV阴性患者肺部隐球菌感染的临床特征。方法 回顾性分析32例HIV阴性患者肺隐球菌感染患者资料。根据结节是否伴有磨玻璃影(GGO)/实变影,将患者分为两组,比较两组的临床特征。结果 32例HIV阴性肺隐球菌感染患者有10例(31.3%)GGO,4例(12.5%)实变影,4例(12.5%)GGO及实变影。单发及多发结节分别为8例(25.0%)、24例(75.0%)。14例结节不伴有GGO/实变影,18例结节伴有GGO/实变影。18例结节伴有GGO/实变影患者的血红蛋白(12.0[8.9~16.5]vs 8.4[4.4~14.9])和血小板(24.6[10.2~36.0] vs8.4[1.4~30.3])明显低于14例不伴有GGO/实变影患者的血红蛋白和血小板(分别为P=0.0 4 4和P=0.023)。两组患者的性别、年龄、体重指数、初诊症状、糖化血红蛋白、白细胞、淋巴细胞、白蛋白、血沉、C反应蛋白、免疫球蛋白的差异无统计学意义。结论 肺结节伴有GGO/实变影的HIV阴性隐球菌感染患者的血红蛋白和血小板低于肺结节不伴有GGO/实变影的HIV阴性隐球菌感染患者。

Objective To analyze clinical characteristics of pulmonary cryptococcal infection in HIV-negative patients with different CT findings. Methods Medical records of 32 HIV-negative patients with pulmonary cryptococcosis diagnosed at our institution were retrospectively analyzed. CT examinations were obtained with a multidetector row CT scanner. The clinical characteristics of 14 patients with nodules without ground-glass opacity(GGO)/consolidation type were compared with those of 18 patients with inclusive GGO or consolidation type. Results 10(31.3%) cases of GGO, 4(12.5%) cases of solid shadows, and 4(12.5%) cases of GGO and solid shadows were seen in 32 HIV negative patients with pulmonary cryptococcus infection. 8(25.0%) patients with single nodule and 24(75.0%) patients with multiple nodules were showed. There were 14 patients without GGO/consolidation, and 18 patients with GGO/consolidation. Most lesions were located in the lower lobes. The levels of hemoglobin[12.0(8.9~16.5) vs 8.4(4.4~14.9)] and platelets [24.6(10.2~36.0) vs 8.4(1.4~30.3)] were significantly lower in patients with inclusive GGO or consolidation type compared with those of patients without GGO or consolidation(P=0.044 and P=0.023, respectively). There was no statistically significant difference in sex, age, body mass index, symptoms at initial consultation, HbA1c, WBC, lymphocytes,albumin, ESR, CRP, and IgG. Conclusion The levels of hemoglobin and platelets were lower in patients with GGO or consolidation compared with those of patients without GGO or consolidation.