CAJ | 학술논문

目的：探讨经高效抗逆转录病毒治疗发生免疫重建炎性综合征(IRIS)的艾滋病患者胸部淋巴结 CT 表现。方法收集24例经高效抗逆转录病毒治疗后发生免疫重建炎性综合征出现胸部淋巴结增大的艾滋病患者胸部 CT 资料,分析其胸部 CT 表现。结果24例艾滋病患者合并肺结核19例,其中5例合并颈部淋巴结结核,合并马尔尼菲青霉菌感染1例,合并卡氏肺孢子菌感染1例,合并细菌、真菌混合性感染3例。24例患者胸部增大淋巴结分布于不同部位,主要位于4R 区(20/24),其次见于2R 区(11/24),4L 区(11/24),其密度均匀或不均匀,边界清楚或不清楚,部分淋巴结融合,无钙化。X 区淋巴结短径约23.0~42.0 mm,其他区淋巴结短径约11.0~25.0 mm。2例增强扫描淋巴结均匀强化；2例10R 区淋巴结增大患者出现阻塞性肺炎、肺实变；13例出现胸腔积液,最深约22 mm；5例出现心包积液,最深约24 mm。结论艾滋病发生免疫重建炎性综合征患者胸部增大淋巴结可见于不同部位,主要累及4R、2R、4L 区,伴或不伴胸腔积液、心包积液。
목적：탐토경고효항역전록병독치료발생면역중건염성종합정(IRIS)적애자병환자흉부림파결 CT 표현。방법수집24례경고효항역전록병독치료후발생면역중건염성종합정출현흉부림파결증대적애자병환자흉부 CT 자료,분석기흉부 CT 표현。결과24례애자병환자합병폐결핵19례,기중5례합병경부림파결결핵,합병마이니비청매균감염1례,합병잡씨폐포자균감염1례,합병세균、진균혼합성감염3례。24례환자흉부증대림파결분포우불동부위,주요위우4R 구(20/24),기차견우2R 구(11/24),4L 구(11/24),기밀도균균혹불균균,변계청초혹불청초,부분림파결융합,무개화。X 구림파결단경약23.0~42.0 mm,기타구림파결단경약11.0~25.0 mm。2례증강소묘림파결균균강화；2례10R 구림파결증대환자출현조새성폐염、폐실변；13례출현흉강적액,최심약22 mm；5례출현심포적액,최심약24 mm。결론애자병발생면역중건염성종합정환자흉부증대림파결가견우불동부위,주요루급4R、2R、4L 구,반혹불반흉강적액、심포적액。
Objective To explore the CT appearance of thoracic lymphonodus in AIDS patients with immune reconstitution in-flammatory syndrome(IRIS)after highly active antiretroviral therapy (HAART).Methods The data of thoracic CT in 24 AIDS pa-tients after HAART with enlarged thoracic lymphonodus in IRIS were collected,and the chest CT appearance was analyzed.Results Of the 24 cases of AIDS patients with IRIS after HAART,1 9 cases were complicated with pulmonary tuberculosis,which includ-ed 5 cases with cervical tuberculous lymphadenitis,3 cases were co-infected with bacterium and fungi,1 case was infected by penicil-lium marneffei,1 case by pneumocystis carinii.The enlarged thoracic lymphonodus were primarily located in 4R region(20/24), secondly in 2R region(1 1/24)and 4L region(1 1/24),in which the density was uniform or non-uniform,edge clear or unclear,some parts of lymphonodus were fused together but not calcified.The minor axis of enlarged lymphonodus was 1 1.0-25.0 mm except X region,enhanced uniformly in 2 cases.Obstructive pneumonia and pulmonary consolidation were found in 2 cases with enlarged lym-phonodus,which were located in 10R region.Pleural effusion was found in 13 cases with greatest depth of about 22 mm,pericardial effusion was found in 5 cases with greatest depth of about 24 mm.Conclusion The enlarged thoracic lymphonodus in AIDS patients with IRIS affer HAART are mainly involved in the region of 4R,2R and 4L,with or without pleural effusion and pericardial effusion.