中国防痨杂志2017，Vol.39Issue(6)：581-586,6.DOI:10.3969/j.issn.1000-6621.2017.06.008
艾滋病并发纵隔淋巴结结核的CT表现及临床特征
The CT manifestations and clinical features in AIDS patients with mediastinal lymph node tuberculosis
摘要
Abstract
Objective To investigate the CT manifestations and clinical features in patients with acquired immunodeficiency syndrome (AIDS) complicated with mediastinal lymph node tuberculosis in order to improve diagnostic ability.Methods We analyzed retrospectively the data of CT manifestations and clinical features from 132 cases with AIDS complicated with mediastinal lymph node tuberculosis confirmed by pathology or clinical (as complicated group) and 132 cases with mediastinal lymph node tuberculosis (as control group) in Beijing Ditan Hospital during July 2013 to January 2016.The CT manifestations and clinical features were compared in two groups.Results The rate of acid fast bacilli (10.6%,14/132) in the complicated group was lower than that (47.0%,62/132) in control group with significant difference statistically (χ2 value 42.57 and P<0.01).The CD4 lymphocyte count (196×106(106-307×106)) in the complicated group was significantly lower than that (786×106/L(435×106-977×106/L)) in the control group (Z=55.75,P<0.01).Pulmonary tuberculosis was common in patients with AIDS (69.7%,92/132).The rate of hematogenous disseminated pulmonary tuberculosis,pleural effusion, pericardial effusion, tuberculosis of abdominal lumph nodes and tuberculosis of spleen complicated in the complicated group (24.2% (32/132),30.3% (40/132),21.2% (28/132),13.6% (18/132) and 12.1% (16/132)) were higher than those (8.3% (11/132),15.9% (21/132),8.3% (11/132),6.1% (8/132),3.8% (5/132)) in the control group with significant difference statistically (χ2 value were 12.25, 9.90, 8.70, 4.27 and 6.26,P value were less than 0.01, 0.01, 0.01 and equal to 0.039 and 0.012).The rate of three or more group lymph nodes involved, lymph node fusion, lymph node with diameter more than 2.0 cm and heterogeneous enhancement of lymph node (80.3% (106/132),72.0% (95/132),65.2% (86/132) and 84.8% (112/132)) in the complicated group were higher than those (42.4% (56/132),34.8% (46/132),32.6% (43/132) and 40.9% (54/132)) in the control group with significant difference statistically (χ2 value were 39.94,36.55,28.03 and 54.59,P<0.01 for all).The rate of homogeneous enhancement, non-enhancement and calcification of lymph node (9.1% (12/132),6.1% (8/132)and 6.1% (8/132)) in the complicated group were lower than those (36.4% (48/132),22.7% (30/132) and 19.7% (26/132)) in the control group with significant difference statistically (χ2 value were 27.95, 14.87 and 10.94,P<0.01, 0.016 and <0.01).Conclusion The characteristics of more heterogeneous enhancement, three group lymph node involved, less calcification, less sputum smear acid fast bacilli positive and low CD4 lymphocyte count in AIDS patients complicated with mediastinal lymph node tuberculosis were helpful to diagnose this disease.关键词
获得性免疫缺陷综合征/纵隔疾病/结核,淋巴结/体层摄影术,X线计算机/对比研究Key words
Acquired immunodeficiency syndrome/Mediastinal diseases/Tuberculosis,lymph node/Tomography,X-ray computed/Comparative study引用本文复制引用
薛明,李晶晶,吕志彬,崔涛,陈七一,张紫欣,谢汝明..艾滋病并发纵隔淋巴结结核的CT表现及临床特征[J].中国防痨杂志,2017,39(6):581-586,6.基金项目
感染病科国家临床重点专科建设项目(2014-04-18) （2014-04-18）
