HIVTB合并感染的胸部影像学特征.docVIP

精品论文 参考文献 HIVTB合并感染的胸部影像学特征 杨丹1 陈耀凯2 吕圣秀3 郭述良1（通讯作者） 　　（1重庆医科大学附属第一医院呼吸内科、呼吸与危重学科 400016） 　　（2重庆市公共卫生医疗救治中心感染二科 400036） 　　（3重庆市公共卫生医疗救治中心放射科 400036） 　　【摘要】 人类免疫缺陷病毒（HIV）感染者发生活动性结核病（TB）称为HIV/TB合并感染。与HIV阴性结核病患者相比，HIV/TB合并感染者在胸部影像学表现上具有某些特殊表现，如：（1）病变范围广泛，好发部位不典型；（2）血行播散型肺结核及肺外结核更常见；（3）以渗出、增殖、干酪样坏死等急性病灶为主，且常表现为两种以上形态；（4）纵隔及肺门淋巴结肿大发生率高。熟悉HIV/TB合并感染者胸部影像学特征有助于做出及时、正确的诊断，进而有助于及时治疗和减少病死率。本文就HIV/TB合并感染的病理改变以及由此产生的胸部影像学（胸部X片、CT）特征进行综述。 　　【关键词】艾滋病 结核病 合并感染 影像学 　　【中图分类号】R445 【文献标识码】A 【文章编号】2095-1752（2014）05-0046-03 　　 　　Radiographical characteristics in patients coinfected with human immunodeficiency 　　virus and tuberculosis 　　YANG Dan1，CHEN Yao-kai2，LV Sheng-xiu3，GUO Shu-liang1 　　（1.Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital Of Chongqing Medical University, Chongqing 400016；2. Second Department of Infectious Diseases,Chongqing Public Health Medical Center, Chongqing 400036;3. Radiology Department, Chongqing Public Health Medical Center, Chongqing 400036） 　　【Abstract】Patients with both human immunodeficiency virus (HIV) infection and tuberculosis (TB) are referred to as HIV/TB co-infected patients, who have different radiographic findings. For example, pulmonary lesions are less likely to be contained within upper lobes and back lower lobes, with other parts of the lung affected easily; disseminated TB and extrapulmonary TB are more common compared with HIV negative TB patients; types of lesion are more complicated and lymphadenopathy is more common in the mediastinum and hilum in co-infected cases. Familiarizing with these particular characteristics is conducive to the diagnosis and treatment of HIV/TB co-infection, and is helpful to reducing mortality in co-infected patients. In this article, pathological change and according imaging characteristics in HIV/TB co-infected patients are reviewed. 　　【Key words】human immunodeficiency virus tuberculosis coinfection r