| Background and purposeAIDS is a very harmful infectious disease in clinical treatment.The main cause is that patients are infected with HIV,which can cause serious damage to the human immune system.According to clinical research results,HIV mainly acts on CD4T lymphocytes in the human immune system,causing a large number of damage to such cells,resulting in disorders of the body's immune system.Because HIV destroys human immune cells,resulting in low immune system function,when the human body's immunity is low,it is prone to various opportunistic infections of the lungs and eventually lead to death,the most common of which is tuberculosis.Tuberculosis is caused by pulmonary infection caused by Mycobacterium tuberculosis,which is a common chronic respiratory disease.The criteria for judging whether pulmonary tuberculosis is infectious are:sputum bacteria are positive or negative;only tuberculosis with positive results is infectious,negative is not infectious.The purpose of this study is to explore the differences in clinical manifestations,laboratory examinations and CT manifestations between AIDS complicated with tuberculosis and varnous opportunistic infections of the lungs,so as to improve the diagnostic rate of CT manifestations of AIDS complicated with tuberculosis by radiologists and provide help for timely and effective treatment of AIDS patients.Method212 AIDS patients diagnosed clinically in our hospital from December 2015 to July 2017 were collected.Among them,100 cases were complicated with tuberculosis.Among them,34 cases were positive for acid-fast bacilli in sputum examination,14 cases were confirmed by sputum culture,and 52 cases were confirmed by clinical experimental medication.Among them,56 cases were diagnosed with general infection,37 cases with Pneumocystis pneumonia,6 cases with negative coccal infection and 12 cases with Penicillium mamei.The diagnosis was confirmed by laboratory diagnosis.The number of CD4 + cells and CT findings were compared and analyzed.Among 212 AIDS patients,60 were complicated with chronic obstructive pulmonary disease(COPD).Their age and CD4 + cell count were collected and analyzed.The relevant data of all patients,including age,sex and other general data,as well as HIV infection routes,positive diagnostic results and other related clinical data were collected and collated to identify the CT imaging features of patients with different opportunistic infections.Result1.Among 56 cases of AIDS complicated with general infection,32 cases(57.1%)had CD4 + cells more than 200/mm3,24 cases(42.9%)had CD4 + cells less than 200/mm35 and most of the CD4 + cells were more than 200/mm3.Of the remaining 156 cases of AIDS complicated with opportunistic infection,62 cases had CD4 cells over 200/mm3,while 94 cases had CD4 cells below 200/mm3.There were significant differences in the results of data comparison between groups,with statistical significance(P<0.05).2.Among the 100 cases of AIDS complicated with tuberculosis,68 cases had multiple lobes of both lungs.The incidence of upper lobes of both lungs was slightly higher than that of lower lobes.AIDS complicated with tuberculosis was divided into three groups according to the number of CD4 +cells.Group A,28 cases were>200/mm3,Group B,20 cases were 100-200/mm3,and Group C,52 cases were CD4+<100/mm3.The distribution range and pathological changes of the three groups had statistical significance(P<0.05).3.There was no significant difference in the data of lung distribution between AIDS patients with pulmonary tuberculosis and those with common bacterial infection(P>0.05),but there was significant difference in the pathological changes between the two groups(P<0.05).4.The main route of transmission of AIDS patients is sexual transmission.The age is mainly between 40 and 50 years old.Males are more than females.Farmers are the main occupations.62(62%)of 100 AIDS patients with tuberculosis are accompanied by fatigue and emaciation.34 cases(34%)were positive for acid-fast bacilli.5.After HAART treatment,AIDS combined with general infection and tuberculosis,most of the lesion absorption improved,a few lesions progress;AIDS combined with fungal infection,most of the focus progress,a small number of focus absorption.In 50 cases of AIDS complicated with pulmonary tuberculosis,the average number of CD4+ cells in progression of lesions was lower than that of CD4+cells.conclusionCT imaging of AIDS complicated with pulmonary tuberculosis is mostly multi-lobe distribution.At the same time,the incidence of common upper lobe lesions in both lungs is higher than that in lower lobe lesions.Detection of CD4 + cell content can effectively identify AIDS patients with different opportunistic infections.According to the cell expression level of AIDS patients with pulmonary tuberculosis,it can be divided into>200,100-200 and<100(/mm3).CT diagnosis results show that pulmonary plaques and nodules in patients with pulmonary tuberculosis are bilateral.It was more obvious with stripe shadow,bilateral pulmonary exudation,bilateral pulmonary plaques,nodules and stripe shadow were common;diffuse nodules and stripe shadow depression were accompanied by bilateral hilar lymph node enlargement.CT images of AIDS patients with general bacterial infections are mostly patchy.When the cell expression of AIDS patients with pulmonary tuberculosis is more than 200,pleural effusion,nodules and lymph node enlargement are prominent,which can be effectively identified. |
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