关键词: 获得性免疫缺陷综合征, 结核,淋巴结, 共病现象, 体层摄影术,X线计算机, 疾病特征

Abstract:

Objective To investigate the clinical features and CT characteristics of acquired immune deficiency syndrome (AIDS) complicated with cervical lymph node tuberculosis. Methods From Jan 2015 to July 2019, 142 clinical data of initial inpatients who diagnosed with cervical lymph node tuberculosis by cervical lymph node biopsy or postoperative histopathological examination at the Fourth People’ Hospital of Nanning were collected. These patients were divided into two groups based on whether complicated with AIDS: complicated group (AIDS with cervical lymph node tuberculosis, 42 cases) and non-complicated group (AIDS without cervical cancer without tuberculosis, 100 cases), and then the clinical characteristics and CT manifestation of the two groups were compared and analyzed. Results In the complicated group, several factors, including the proportion of male, age, cough ratio, fatigue ratio and fever ratio, were significantly higher than those in the non-complicated group (66.7% (28/42) vs 44.0% (44/100), χ ²=6.867, P=0.009; 41.69 (34.75, 47.00) years vs 30.64 (22.00, 32.75) years, Z=-5.300, P=0.000; 26.2% (11/42) vs 9.0% (9/100), χ ²=7.223, P=0.007; 16.7% (7/42) vs 1.0% (1/100), χ ²=10.867, P=0.001; and 38.1% (16/42) vs 8.0% (8/100), χ ²=13.339, P=0.000, respectively); however, the CD4 ⁺ T lymphocyte count (152.50 (69.25, 241.75) cells/μl) in the complicated group was obviously lower than that (598.00 (452.00, 748.00) cells/μl) in the non-complicated group (Z=-8.081, P=0.001). In addition, in the complicated group, several CT manifestations, including lymph nodes with a short diameter >2 cm (47.6% (20/42)), lymph node fusion (71.4% (30/42)), coexistence of complete and incomplete necrosis of the lymph nodes (45.2% (19/42)), involvement ≥3 areas (59.5% (25/42)) and involvement ≥4 areas (33.3% (14/42)), were significantly higher than those in the non-complicated group (27.0% (27/100), 53.0% (53/100), 4.0% (4/100), 31.0% (31/100), and 11.0% (11/100), respectively) (χ ²= 5.679, 4.136, 37.056, 10.075, and 10.170, respectively, all P<0.05), while the regular lesions (16.7% (7/42)), the clear borders (16.7% (7/42)), and incomplete necrosis (33.3% (14/42)) were remarkably lower in the complicated group than those (50.0% (50/100), 52.0% (52/100), and 90.0% (90/100)) in the non-complicated group (χ ²=13.677, 15.205, and 48.459, respectively, all P=0.000). Conclusion AIDS complicated with cervical lymph node tuberculosis usually occurred in males and patients over 40 years of age, as well as exhibited atypical clinical characteristics and significantly reduced CD4 ⁺ T lymphocyte counts. CT manifestations of these patients usually exhibited are more common for lymph nodes with a short diameter >2 cm, fusion, unclear borders, irregular morphology, lesions involved lymph nodes ≥ 3 areas, and more mixed necrosis.

Key words: Acquired immunodeficiency syndrome, Tuberculosis,lymph node, Comorbidity, Tomogrphy,X-ray computer, Disease attributes