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目的探讨CD4 T淋巴细胞低水平状态下的AIDS患者合并肺部真菌感染的影像学表现的特征。方法对确诊的33例CD4T淋巴细胞计数≤100个/mm3的AIDS合并肺部真菌感染的患者的发病部位、范围及影像特征进行分析。结果 AIDS合并真菌感染的患者中以念珠菌感染最常见,与其他真菌的发生率的差异具有统计学意义(P=0.000)。两肺病灶呈弥漫分布;发生率在各叶间的差异无统计学意义(P=0.221);影像特征以斑片或大片实变影多见,与结节影、空洞影、胸腔积液、纵隔内淋巴结肿大、真菌球的发生率之间差异具有统计学意义(P=0.000)。结论艾滋病合并肺部真菌感染时病变范围广,具有不典型性;因此对肺部感染进行常规抗菌治疗效果不理想时应及时进行HIV检查及真菌检查。
Objective To investigate the imaging features of pulmonary fungal infection in AIDS patients with low CD4 T lymphocyte subsets. Methods The incidence, extent and imaging features of 33 confirmed cases of AIDS patients with pulmonary fungal infection who had CD4T lymphocyte count ≤100 / mm3 were analyzed. Results Candida infection was the most common in patients with AIDS complicated with fungal infection, and the difference with other fungi was statistically significant (P = 0.000). The two lung lesions were diffusely distributed, and the incidence was not significantly different among the leaves (P = 0.221). The features of the image were more common with patchy or large consolidation, and with nodules, empty shadow, pleural effusion, Mediastinal lymph nodes, the incidence of fungal ball difference was statistically significant (P = 0.000). Conclusion A wide range of pathological changes are found in AIDS complicated with pulmonary fungal infection. Therefore, HIV infection and fungal infection should be promptly checked when the effect of routine antibacterial therapy on pulmonary infection is not satisfactory.