[目的]提高艾滋病(AIDS)机会性胸部感染的诊断准确率.[方法]回顾性分析AIDS机会性胸部感染55例的相关临床资料及X线胸片表现.[结果]55例来源于AIDS高危人群,有HIV传播途径历史,并有相应的全身及肺部的临床表现,HIV抗体检测均阳性.X线表现为:肺结核24例(43%),其中小片状融合的渗出性病灶及条索影12 例,两肺弥漫性小结节影7 例,胸内淋巴结肿大5例;卡氏肺囊虫肺炎18例( 33 % ),其中两侧肺门及中下肺野网眼状、小片状或斑片状影10 例,两肺弥漫性或局限性毛玻璃影8例; 细菌性感染7例( 13 % ),其中片状实变影4例,段或叶分布的局灶性实变2例,空洞1例;真菌性感染6例(11% ),其中肺间质网状影3例,胸腔积液2例,肺门淋巴结肿大1 例.[结论]AIDS机会性胸部感染的X线表现缺乏特异性,对于其高危人群有久治难愈的肺部症状,应首先考虑肺部机会性感染,确断还必须结合相应的临床症状与体征与和HIV检测结果.%[Objective] To improve the diagnostic accuracy of opportunity chest infection in patient with acquired immunodeficiency syndrome(AIDS). [Methods] The clinical data and chest X-ray manifestations in 55 cascs of AIDS with opportunity infection were analyzed retrospectively. [Results] All 55 cases were from high risk population of AIDS and had the history of HIV transmission and the clinical symptoms of whole body and pulmonary. Their HIV antibodies were positive. The X-ray appearances were pulmonary tuberculosis in 24 cases(43％) including 12 cases of effusion lesion with little fragment fusion and trabs shadow, 7 cases of diffuse module shadow of both lungs and 5 cases of chest lymphadenectasis, and pneumocystis carinii pneumonia in 18 cases(33％) including 10 cases of mesh, little fragment or plaque shadow of hilus pulmonis and lower field and 8 cases of diffuse or focal clouded glass shadow, bacterial infection in 7 cases(13％)including 4 cases of slabby consolidation shadow, 2 cases of segment- or lobe-like focal consolidation and 1 case of cavity,and fungal infection in 6 cases(11％) including 3 cases of rcticular shadow of lung mesenchymal, 2 cases of pleural effusion and 1 case of hilar lyrnphadenectasis. [Conclusion] The X-ray appearance of AIDS with opportunity chest infection is nor specific. For high-risk population with refractory lung lesion, pulmonary opportunity infection should be considered.The combination of clinical symptoms, signs and HIV results should be used for the final diagnosis.
展开▼
