AIDS合并肺孢子菌肺炎不同分期的CT影像学表现差异与细胞免疫学功能分析

Differences in CT Imaging Findings and Cellular Immune Function Analysis in Different Stages of AIDS Complicated with Pneumocystis Pneumonia

目的探讨艾滋病(AIDS)合并肺孢子菌肺炎不同分期的CT影像学表现差异及细胞免疫学功能。方法回顾2018年1月至2022年8月期间医院收治的86例AIDS合并肺孢子菌肺炎患者的临床资料。患者均在院接受CT诊断,并对患者进行细胞免疫功能检查,分析不同分期患者CT影像学表现及细胞免疫功能差异。结果86例AIDS合并PCP患者中,早中期组患者42例,晚期组44例。两组患者CT具体表现磨玻璃影、网格结节影等征象比较(P>0.05),但早中期组患者纤维条索状影、囊变影或空腔性病变、混合型低于晚期组,“月弓征”高于晚期组(P<0.05)。晚期组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(^(+))、NK细胞水平及CD4^(+)T淋巴细胞计数均低于中早期组(P<0.05)。囊变型患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞水平及CD4^(+)T淋巴细胞计数最低,其次是混合型、间质型、实变型、囊变型及磨玻璃型(P<0.05)。结论AIDS合并肺孢子菌肺炎患者存在一定的CT影像学特征,晚期患者免疫细胞水平降低,且多存在纤维条索状影、囊变影或空腔性病变、混合型特征,临床应加强其认识,提高疾病诊断率。

ObjectiveTo investigate the differences in CT imaging findings and cellular immune function of AIDs complicated with Pneumocystis pneumonia in different stages.MethodsThe clinical data of 86 AIDs patients with Pneumocystis pneumonia admitted to the hospital from January 2018 to August 2022 were reviewed.All patients received CT diagnosis in the hospital,and the cellular immune function was examined.The differences in CT imaging findings and cellular immune function of patients with different stages were analyzed.ResultsAmong the 86 AIDs patients with PCP,there were 42 patients in the early and middle stage group and 44 patients in the late stage group.The specific CT manifestations of ground-glass opacity,grid nodules and other signs were compared between the two groups(P>0.05),but the fibrous cord shadows,cystic opacities or cavity lesions,and mixed types in the early and mid-stage groups were lower than those in the late-stage group.,the"moon bow sign"was higher than that in the late group(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells and CD4^(+)T lymphocyte count in the advanced group were lower than those in the middle and early group(P<0.05).Patients with cystic degeneration had the lowest levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells and CD4^(+)T lymphocyte count,followed by mixed type,stromal type,consolidation type,cystic type and ground glass type(P<0.05).ConclusionThere are certain CT imaging features in patients with AIDs complicated with Pneumocystis pneumonia.The level of immune cells in advanced patients is decreased,and fibrous streak shadows,cystic shadows or cavity lesions,and mixed features are often found in patients with advanced disease.Clinical understanding should be strengthened.,improve the diagnosis rate of disease.