Objective To study CD4+T cells pathogenic bacteria distribution and CT imaging in patients with AIDS complicated with tuberculosis. Methods 90 patients with AIDS complicated with tuberculosis were divided into the observation group (40 cases) and the control group (50 cases). Their CD4+T cells distribution of pathogens and CT imaging findings were compared. Results Cord shadow, miliary shadow, pericardial effusion and pleural effusion showed no statistical significance (P＞ 0.05), but the distribution of node shadow, patching shadow and miliary shadow showed significant difference between the two groups (P ＜ 0.05). While CD4+T cells ＜ 100, typical tuberculosis was statistically lower than atypical tuberculosis. While CD4+T cells＞ 200, typical tuberculosis was statistically higher than atypical tuberculosis. While CD4+T cell ＜ 50, its CT imaging performance distribution rate was significantly higher than at 50-100. The difference in gram-positive bacteria and fungi had no significance between the two groups (P＞ 0.05). Gram-negative bacteria (16.2％) of the observation group was significantly lower than that in the control group (32.5％). (P ＜ 0.05). Conclusion The chest CT images of AIDS patients are mostly atypical, mainly due to the reduction of CD4+T cells. Understanding the relationship between the image characteristics of AIDS patients with pulmonary tuberculosis and CD4+T cells can effectively prevent and treat AIDS patients.%目的 分析AIDS合并肺结核CD4+T细胞、病原菌分布及其CT影像学检查结果,为患者的诊疗提供临床指导.方法 回顾性分析2016年7月-2017年7月我院90例肺结核患者的诊疗情况,按照患者是否合并AIDS状况,分为观察组(40例)和对照组(50例).将观察组分为典型肺结核组(8例)和不典型肺结核组(32例).观察患者的CD4+T细胞、病原菌分布及其CT影像学检查结果.结果 观察组和对照组两组患者条索阴影、粟粒阴影、心包积液、胸腔积液分布率无显著差异变化(P＞ 0.05);而结点阴影、斑片阴影、粟粒阴影等其他指标分布率则差异变化明显,具有统计学意义(P ＜0.05).在CD4+T细胞＜100区间内,典型肺结核组明显低于不典型肺结核组;而在＞ 200范围内,典型肺结核组显著高于不典型肺结核组.不典型肺结核患者的CD4+T细胞在＜50范围内,CT影像学表现分布率明显高于在50-100范围内.观察组和对照组的革兰阳性菌和真菌变化差异不明显,无统计学意义(P＞ 0.05);观察组的革兰阴性菌(16.2％)显著低于对照组的32.5％,差异具有统计学意义(P ＜0.05).结论 AIDS患者胸部CT影像多表现为不典型,主要因为CD4+T细胞减少所致.了解AIDS合并肺结核患者影像特征与CD4+T细胞的关系,可有效预防并治疗AIDS患者.
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