艾滋病机遇性胸部感染的X线平片表现

目的: 提高艾滋病机遇性胸部感染的诊断水平.材料和方法: 回顾性分析艾滋病机遇性胸部感染50例的X线胸片及相关临床资料.结果: 肺结核21例(42%),片状融合的渗出性病灶13例,弥漫性粟粒影6例;胸内淋巴结肿大9例;卡氏肺囊虫肺炎16例(32%),双侧肺门及中下肺野可见网状、小点状影,片絮状或斑片状影10例,两肺弥漫性或局限性磨玻璃影8例;细菌性感染8例(16%),片状实变影7例,肺结块影并空洞1例;真菌性感染5例(10%),弥漫粟粒样小结节影3例,肺门淋巴结肿大1例.结论: 艾滋病机遇性胸部感染的X线表现缺乏特征性,诊断须结合临床与实验室检查,并注意发病率较高的肺结核与卡氏肺囊虫肺炎.

Radiographic Features of Opportunity Chest Infection in Patient with AIDS

Purpose: To improve the radiographic diagnosis of opportunity chest infection in patient with acquired immunodeficiency syndrome (AIDS). Materials and Methods: The radiographic features and clinical data of 50 AIDS patients with opportunistic chest infection were retraspectively analysed. Results: The radiographic appearances of 21(42%) patients with pulmonary tuberculosis (PTB) included patchy confluent exudative foci (13 cases), diffuse military tuberculosis ( 6 cases ), enlarged intrathoracic lymph nodes ( 9 cases). Of 16 (32%) patients with pneumocystis carnii pneumonia (PCP), 10 had diffuse reticular or reticulo-nodular infiltrates and alveolarconsolidation, and 8 had ground-glass change with bilateral hilar regions and middle-lower lunge fields. 8 (16%) patients with bacterial pneumonia revealed focal consolidation which typically presented in either a segmental or lobar distribution (7 cases ), and lunge nodules and cavities(1 case ). 5 (10%) patients with fungus pneumonia showed military nodules (3 cases) and lymphadenopathy (1 case ). Conclusion: Radiographic findings of opportunity chest infections in patient with AIDS are often nonspecific for pneumonias, so diagnosis must be associated with clinic and laboratory data. Both PTB and PCP should firstly be taken into consideration once pulmonary abnormal is present.