影像学CT特征与血清TNF-α对HIV感染合并肺结核的诊断价值

CT imaging features and value of serum TNF-αin diagnosis of HIV infection complicated with pulmonary tuberculosis

目的分析影像学CT特征与血清肿瘤坏死因子α(TNF-α)对人类免疫缺陷病毒(HIV)感染合并肺结核的诊断价值。方法选取2016年6月-2020年6月遵义医科大学第三附属医院就诊的HIV感染合并肺结核患者52例为研究组,将同时期医院接诊的50例单纯肺结核患者为对照组。收集患者入院第1天肺部CT检查结果及血清TNF-α水平,受试者工作特征(ROC)曲线分析其对HIV感染合并肺结核的诊断价值。结果与对照组相比,研究组斑片实变、多发空洞、胸腔积液、多发结节、淋巴结肿大患者占比及TNF-α水平升高,单发空洞患者占比降低,差异具有统计学意义(P<0.05)。研究组不同结核分型患者血清TNF-α水平比较差异有统计学意义(P<0.05),其中与I型患者相比,Ⅱ、Ⅲ、Ⅳ型TNF-α水平升高(P<0.05),与Ⅱ型患者相比,Ⅲ、Ⅳ型TNF-α水平升高(P<0.05),与Ⅲ型患者相比,Ⅳ型TNF-α水平升高(P<0.05)。与斑片实变、单发空洞、多发空洞、胸腔积液、多发结节、淋巴结肿大、TNF-α水平单项诊断相比,七项联合对HIV感染合并肺结核肺的诊断价值较高(P<0.05)。结论HIV感染合并肺结核可以使用影像学CT特征及血清TNF-α进行诊断,诊断价值较高,具有使用价值。

OBJECTIVE To investigate the CT imaging features and analyze the value of serum tumor necrosis factor-α(TNF-α)in diagnosis of human immunodeficiency virus(HIV)infection complicated with pulmonary tuberculosis.METHODS Totally 52 HIV infection patients who were complicated with pulmonary tuberculosis and treated in the Third Affiliated Hospital of Zunyi Medical University from Jun 2016 to Jun 2020 were assigned as the study group,meanwhile,50 patients with simple pulmonary tuberculosis were chosen as the control group.The CT imaging examination data and serum TNF-αlevel were collected from the patients on the lst day of enrollment,and the value of serum TNF-αin diagnosis of HIV infection complicated with pulmonary tuberculosis was analyzed by receiver operating characteristic(ROC)curve.RESULTS The proportions of patients with plaque consolidation,multiple cavities,pleural effusion,multiple nodules and lymph node enlargement and the TNF-αlevel were significantly higher in the study group than in the control group,while the proportion of patients with single cavity of the study group was significantly lower than that of the control group(P<0.05).In the study group,there was significant difference in the serum TNF-αlevel among the patients with different types of tuberculosis(P<0.05);the TNF-αlevel of the type II,II and IV patients was significantly higher than that of the type I patients(P<0.05);the TNF-αlevel of the type II,IV patients was significantly higher than that of the type II patients(P<0.05);the TNF-αlevel of the type IV patients was significantly higher than that of the type II patients(P<o.05).As compared with the single index of plaque consolidation,single caviry,multiple cavities,pleural effusion,multiple nodules,lymph node enlargement and the TNF-α,the joint detection of the seven indicators had higher value in diagnosis of HIV infection complicated with pulmonary tuberculosis(P<0.05).CONCLUSION HIV infection complicated with pulmonary tuberculosis can be diagnosed with CT imaging features and serum TNF-α,which have high diagnostic value.