CAJ | 학술논문

目的：探讨AIDS患者血清癌胚抗原（CEA）增高与胸部病变的关系。方法观察2008年1月至2011年12月间因胸部疾病入住四川省达州市中心医院呼吸内科且确诊为AIDS感染者，选取同时有胸部CT检查及血清CEA检测资料的病例68例，包括男性54例，女性14例，年龄26～78岁，平均年龄51.10岁，分析临床病史、症状、胸部CT影像学变化与血清CEA水平之间的关系。结果68例AIDS患者中，CEA增高者占44.12%，平均年龄较CEA正常组偏大3.22岁；发热、咳嗽症状患者两组间比例接近，主诉气促及合并真菌感染者是CEA正常者的1倍，而乏力盗汗、胸部不适等其他主诉则约是CEA正常者的1/2（47.83%）。CEA正常组的均值是（2.04±1.34）ng/ml，CEA增高组为（8.28±4.54）ng/ml；组间差异有显著统计学意义（P ＜0.001），CEA增高组发生胸部磨玻璃影（GGO）的几率是CEA正常者的4倍，而CEA正常组斑片影则约为CEA增高组的1倍；AIDS患者胸部GGO影像的密度和范围不同，其CEA的平均水平出现相应的水平差异；而未合并GGO的胸部团块影、纵膈增大及纤维索条影者CEA水平在0.00～10.93 ng/ml，与GGO者比较差异有显著统计学意义（P ＜0.001）。结论 AIDS患者血CEA增高可能与胸部磨玻璃影的形成相关，是CEA的一种非肿瘤性特性，可能与PCP感染相关。
목적：탐토AIDS환자혈청암배항원（CEA）증고여흉부병변적관계。방법관찰2008년1월지2011년12월간인흉부질병입주사천성체주시중심의원호흡내과차학진위AIDS감염자，선취동시유흉부CT검사급혈청CEA검측자료적병례68례，포괄남성54례，녀성14례，년령26～78세，평균년령51.10세，분석림상병사、증상、흉부CT영상학변화여혈청CEA수평지간적관계。결과68례AIDS환자중，CEA증고자점44.12%，평균년령교CEA정상조편대3.22세；발열、해수증상환자량조간비례접근，주소기촉급합병진균감염자시CEA정상자적1배，이핍력도한、흉부불괄등기타주소칙약시CEA정상자적1/2（47.83%）。CEA정상조적균치시（2.04±1.34）ng/ml，CEA증고조위（8.28±4.54）ng/ml；조간차이유현저통계학의의（P ＜0.001），CEA증고조발생흉부마파리영（GGO）적궤솔시CEA정상자적4배，이CEA정상조반편영칙약위CEA증고조적1배；AIDS환자흉부GGO영상적밀도화범위불동，기CEA적평균수평출현상응적수평차이；이미합병GGO적흉부단괴영、종격증대급섬유색조영자CEA수평재0.00～10.93 ng/ml，여GGO자비교차이유현저통계학의의（P ＜0.001）。결론 AIDS환자혈CEA증고가능여흉부마파리영적형성상관，시CEA적일충비종류성특성，가능여PCP감염상관。
Objective To approach relative of increased levels of serum carcinoembryonic antigen (CEA) to pathological changes of lunges in patients with acquired immune deficiency syndrome (AIDS). Methods The patients with diagnosed AIDS admitted on the basis of illness in department of respiratory medicine of our hospital (general hospital) from Jan 2008 to Dec 2011 were prospectively observed, in which 68 cases of patients (male 54, female 14, age range 26-78 years old, means 51.10 years old) with serum CEA data and CT detections of thorax were selected, and the relevance among clinical expressions, symptoms, CT image changes of thorax and the leves of serum CEA were analyzed comparatively. Results The results were showed over 5 ng/ml serum levers of CEA (raised serum CEA) were 44.12% in 68 cases of patients with AIDS, there were not significant difference about mean age, the cases of fever and cough between raised serum CEA group and normal serum CEA group, but mean age were the eldest 3.22 year older in higher CEA group than normal groups, there were significant difference in the cases with raised serum CEA levers of chief complaint of short breath and complicating fungal infection, which were double to normal CEA groups, the cases of raised serum CEA of other chief complaints, as anergy, night sweat and chest discomfort were about moiety (a half) (47.83%) to normal CEA group, the mean levers of normal CEA group were (2.04 ± 1.34) ng/ml, but the levers of higher CEA group were (8.28 ± 4.54) ng/ml (P < 0.001), the probability of GGO in lungs of patients suffer from AIDS with raised serum CEA were 4 times of patients with normal CEA groups. The mean CEA levers of AIDS were showed that there were homologus difference with different range and density of chest eikonic GGO in patients with AIDS, but the mean levers of lung glaebule shadow, mediastinum enlargement and fiber item shadow were 0.00-10.93 ng/ml about, there were significant deviation than lungs GGO (P < 0.001). Conclusions There are correlation in the serum heighterned CEA levels with lungs GGO range and density, it is non-tumorous charactenistics, could associate with Pneumocystis carinii pneumonia.