胸片能否对小儿艾滋病做出诊断?

来源 :国外医学(儿科学分册) | 被引量 : 0次 | 上传用户:JXCHZTP999
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作者复习了36例小儿艾滋病(即AIDS)的临床、X线和病理资料。29例有活检或实验室证明;7例无机会性感染,胸部照片有小结节状阴影,为典型的淋巴细胞性间质肺炎(LIP),在作出特异性诊断上,胸部X光并无预见性。结果患儿年龄自3个月至3(1/2)岁。亲人滥用静脉内药物是最常见的危险因素(3/7)。2例同胞中患AIDS;2例父亲患AIDS;2例是海地人;1例接受输血。患儿均有非特异性呼吸道症状,包括咳嗽、发热、呼吸窘迫。血气分析呈现缺氧。2例可触及淋巴结肿大,4例肝大,2例有神经症状,1例伴有胃肠道症状。胸部X线照片:4例入院时正常,均在七个月以内发现胸部病变。6例胸片特点是双侧弥漫性网结状阴影,类似结核病;1例发生胸腔积液;5例在肺门周围或脊柱旁有致密影。仅1例为团块状浸润,外界清楚(在右上叶)。5个月后病变增大。2例支气管充气相分别证实右和左下叶有肺萎陷。 The authors reviewed clinical, radiological and pathological data from 36 pediatric AIDS patients. Twenty-nine had biopsy or laboratory evidence, seven had no opportunistic infections, and chest photographs had nodular shadows typical of lymphocytic interstitial pneumonia (LIP). In a specific diagnosis, chest X-ray was absent Foreseeability. Results The children were from 3 months to 3 (1/2) years old. Relatives abuse of intravenous drugs is the most common risk factor (3/7). Two siblings had AIDS; two had AIDS from their father; two were Haitians; and one received blood transfusions. Children have non-specific respiratory symptoms, including cough, fever, respiratory distress. Blood gas analysis showed hypoxia. Two cases had palpable lymphadenopathy, four cases had hepatomegaly, two cases had neurological symptoms and one case had gastrointestinal symptoms. Chest X-ray: 4 cases were normal at admission, were found within seven months of chest lesions. Six cases of chest radiographs were characterized by diffuse bilateral net-like shadow, similar to tuberculosis; 1 case of pleural effusion; 5 cases of dense shadow around the hilar or beside the spine. Only one case of mass infiltration, the outside world is clear (in the upper right leaf). 5 months after the lesion increased. Two cases of bronchial inflatable phase confirmed the right and left lower lobe lung collapse.
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