艾滋病与艾滋病毒感染者48例临床影像与病理分析

摘要/Abstract

摘要： 目的探讨艾滋病(AIDS)患者和艾滋病毒(HIV)感染者的临床、影像与病理学表现之间的关系。方法回顾性分析AIDS高发区48例患者的临床、影像学与病理学检查资料。所有病例均行影像学检查, 33例行病理学检查。结果本组病例均确认HIV感染, 其中男30例, 女18例。33例经血液传播, 包括输血19例, 非法采血14例;经性传播4例;1例儿童患者推测为母婴垂直传播, 其余传播途径不明。30例因外科疾病入院治疗, 临床和影像学诊断40余种疾病, 包括骨折6例, 创伤2例, 肺病2例, 肝病3例, 消化道疾病6例, 恶性肿瘤6例, 良性肿瘤5例;经病理确诊AIDS相关疾病14例, 包括淋巴瘤2例, 艾滋病相关淋巴结病变3例, 结核病6例, 淋巴结隐球菌病1例, 弓形虫肺炎1例, 肺部巨细胞病毒及曲霉菌混合感染1例;其他均非AIDS指征性疾病, 包括恶性肿瘤4例, 良性肿瘤5例。均与CD4⁺T细胞计数无相关性。结论 AIDS的诊断需要参照流行病学史、临床表现、实验室检查(确定HIV感染及免疫状态)、影像学检查(确定病变部位和范围)以及病理学检查(确定病变性质、类型, 特别是肿瘤性病变), 实行五结合, 才能获得可靠诊断。

关键词: AIDS, HIV感染, 病理学, 影像学

Abstract: Objective To explore the relationship between the clinical, imaging and pathological appearance. Methods 48 cases of AIDS patients and HIV infected person from the high-incidente area of AIDS were detected radiologically in all cases and pathologically in 33 cases. The examination Results were analyzed retrospectively. Results All cases, including 30 men and 18 women, were confirmed to be infected by HIV, and 33 cases were infected by blood including 19 cases by blood transfusion and 14 by illegal blood collection. 4 cases were infected by sexual transmission, 1 child might be infected by his mother, while other transmitted ways in others were unknown. There are 30 patients admitted to hospital for surgical diseases. Among them, more than 40 kinds of diseases were diagnosed by clinician combined with imaging examinations including fracture in 6 cases, trauma in 2 cases, pulmonary diseases in 2 cases, liver diseases in 3 cases, gastrointestinal diseases in 6 cases, malignancies in 6 cases and benign tumors in 5 cases. 14 cases of AIDS related diseases were confirmed by pathologists including lymphoma in 2 patients, lymphadenopathy related to AIDS in 3 patients, tuberculosis in 6 patients, and 1 case of cryptococcosis in lymph node, 1 case of toxoplasma pneumonitis, and 1 case of pulmonary mixed infection with cytomegalovirus(CMV) and aspergillus, respectively. The other diseases are non- indicated diseases to AIDS consisted of 4 patients suffered from malignant tumors, and 5 from benign tumors, all of which were found no relationship to the CD4⁺ cells counts. Conclusions The reliable diagnosis of AIDS must relay on the combination of the 5 items including epidemiologic history, clinical presentations, laboratory examination to confirm the HIV infection and immune state, imaging inspection to make sure the location and bound of the lesions, and pathological detection to determine the properties and kinds of the lesions especially for the tumors.

Key words: AIDS, HIV infection, Pathology, Imaging

刘德纯, 李宏军. 艾滋病与艾滋病毒感染者48例临床影像与病理分析[J]. 新发传染病电子杂志, 2019, 4(3): 152-155.

LIU De-Chun, LI Hong-Jun. Clinical-imaging-pathological analysis of 48 cases of AIDS patients and HIV infected persons[J]. Electronic Journal of Emerging Infectious Diseases, 2019, 4(3): 152-155.

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