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目的探讨人类免疫缺陷病毒(HIV)患者继发卡氏肺囊虫肺炎(PCP)感染治疗的CT影像学表现。方法搜集经临床及病理证实的HIV患者继发PCP 9例,均正规、足量、全程选用复方磺胺甲基异恶唑(SMZ-TMP)治疗,回顾性分析9例患者病程不同时期胸部CT影像表现和治疗的影响。结果 9例胸部CT首次检查表现弥漫性浅淡磨玻璃样影(GGO)2例,GGO伴局限性增粗纹理4例,弥漫性GGO伴弥漫性网状增粗纹理、以及更多融合均匀的肺实变影3例。治疗后3天~8周,GGO完全吸收3例,大部分吸收3例,病灶进展1例,合并其他机遇感染2例,病灶最早有吸收在治疗后第3天。结论 PCP感染主要表现为两肺磨玻璃样改变、网状或斑点状影时,治疗后可完全吸收;两肺弥漫性间质性或实质性均匀阴影,则吸收缓慢,易继发其他感染。
Objective To investigate the CT imaging findings of the treatment of Pneumocystis carinii pneumonia (PCP) infection in human immunodeficiency virus (HIV) patients. Methods A total of 9 patients with PCP secondary to clinical and pathological confirmed HIV were recruited. SMZ-TMP was used in the regimen of regular, adequate and full-term. The chest CT images of 9 patients at different stages of disease were retrospectively analyzed. The impact of performance and treatment. Results Nine cases of thoracic CT were performed for the first time in 2 cases with diffuse glimpse of glass-like ghosts (GGO), 4 cases of limited GGO with enlarged texture, diffuse reticulation of diffuse GGO and more uniform 3 cases of lung consolidation shadow. Three days to eight weeks after treatment, GGO completely absorbed in 3 cases, most of the absorption in 3 cases, 1 case of lesions, combined with other opportunities in 2 cases, the earliest lesions were absorbed in the first 3 days after treatment. Conclusions PCP infection mainly manifests as glass-like changes, reticular or speckle-like shadow on both lungs, which can be completely absorbed after treatment. The diffuse interstitial or substantially uniform shadows of both lungs are slowly absorbed and secondary to other infections.