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Clinical analysis and chest imaging findings of AIDS complicated with pulmonary tuberculosis ( a report of 21 cases)

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Author:
No author available
Journal Title:
CHINA MEDICINE
Issue:
6
DOI:
10.3760/cma.j.issn.1673-4777.2006.06.002
Key Word:
艾滋病;结核

Abstract: 目的提高对艾滋病合并肺结核的认识,掌握其临床特征.方法对21例艾滋病合并肺结核患者的临床资料进行分析.结果影像学改变情况:浸润型肺结核18例(85.7%),病变以两肺上叶为主10例(47.6%),两肺下叶为主8例(38.0%),两肺上、下叶均受累6例(28.5%).肺门淋巴结肿大10例(47.6%),纵隔淋巴结肿大6例(28.5%).空洞形成3例(14.2%),多数较小,洞壁较薄.合并胸膜炎2例.粟粒型肺结核5例(23.8%),表现为两肺弥漫性粟粒状结节状影像,病灶直径2~4 mm.合并丙肝抗体阳性9例(42.8%),结核菌素(PPD)试验阳性5例(23.8%).15例(72.4%)抗结核治疗治愈或完成疗程,15例发生抗结核药物不良反应.结论艾滋病合并肺结核常发病急,症状重,PPD试验阳性率低,影像表现常不典型.临床及放射科医师应重视艾滋病流行的现实,对发热伴X线不典型的肺结核患者,应常规检测HIV抗体,提高艾滋病合并肺结核的警惕性.

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