CAJ | 학술논문

目的探讨艾滋病(AIDS)并发结核患者在高效抗逆转录病毒治疗(HAART)中发生免疫重建炎性综合征(IRIS)的临床特征及影像表现.方法回顾分析4例AIDS并发结核患者在HAART中发生IRIS的临床及影像资料.结果临床见发热4例,乏力及体重减轻3例,腹痛2例,咳嗽、咯痰1例,胸闷、喘憋1例.CT及MRI见颈部和(或)锁骨上区淋巴结增大3例,腹股沟淋巴结增大1例,肺门或纵隔淋巴结增大2例,腹部淋巴结增大1例;肝及肺实质受侵2例,肾、肾上腺、肠系膜、腹膜、腰大肌、脑及皮肤软组织受累1例.以上临床及影像表现均具有临时性及自限性特征,随着抗结核及HAART联合治疗的继续,病情均出现好转.结论 AIDS并发结核患者在HAART中均有可能发生IRIS,影像检查对IRIS的早期诊断、病情监测、疗效评价及治疗具有重要的作用.
목적 탐토애자병(AIDS)병발결핵환자재고효항역전록병독치료(HAART)중발생면역중건염성종합정(IRIS)적림상특정급영상표현.방법 회고분석4례AIDS병발결핵환자재HAART중발생IRIS적림상급영상자료.결과 림상견발열4례,핍력급체중감경3례,복통2례,해수、각담1례,흉민、천별1례.CT급MRI견경부화(혹)쇄골상구림파결증대3례,복고구림파결증대1례,폐문혹종격림파결증대2례,복부림파결증대1례;간급폐실질수침2례,신、신상선、장계막、복막、요대기、뇌급피부연조직수루1례.이상림상급영상표현균구유림시성급자한성특정,수착항결핵급HAART연합치료적계속,병정균출현호전.결론 AIDS병발결핵환자재HAART중균유가능발생IRIS,영상검사대IRIS적조기진단、병정감측、료효평개급치료구유중요적작용.
Objective To explore the clinical characteristics and radiological manifestations of immune reconstitution inflammatory syndrome(IRIS)in acquired immunodeficiency syndrome(AIDS)patients with tuberculosis(TB)during highly active antiretroviral therapy(HAART).Methods The clinical and radiological data in 4 AIDS patients with TB who presented IRIS were analyzed retrospectively.Results The clinical presentations of IRIS in 4 patients included fever(4 cases),weakness and weight loss(3 cases),abdominal pain(2 cases),cough with sputum(1 case),dyspnea(1 case).Cervical and(or)supra-clavicular lymph node enlargement were seen in 3 patients,inguinal lymph node enlargement in 1 patient,abdominal lymph node enlargement in 1 patient,hilar or mediastinal lymph node enlargement in 2 patients,pulmonary parenchyma and liver were involved in 2 patients,the involvement of kidney,adrenal gland,mesentery,peritoneum,psoas,brain and cutis was respectively found in 1 patient.The clinical and radiological presentations of IRIS were temporary and self-limited,improvement can be seen with antituberculosis therapy and HAART. Conclusions It is possible to have IRIS during HAART in AIDS patients with TB.Imaging examinations play an important role in the early diagnosis,monitoting and evaluating the response to therapy of IRIS.