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Chinese Journal of Antituberculosis ›› 2018, Vol. 40 ›› Issue (7): 682-688.doi: 10.3969/j.issn.1000-6621.2018.07.004

• Original Articles • Previous Articles     Next Articles

Correlation analysis of HRCT image features and CD4 + T lymphocyte level in AIDS patients complicated with thoracic tuberculosis

Ming XUE,Jing-jing LI,Shuo YAN,Zhi-bin LYU,Tao CUI,Qi-yi CHEN,Zi-xin ZHANG,Yan-ni DU,Ru-ming XIE()   

  1. Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
  • Received:2018-03-13 Online:2018-07-10 Published:2018-09-07
  • Contact: Ru-ming XIE E-mail:mingrux@163.com

Abstract:

Objective To analyze the high-resolution computed tomography (HRCT) image features in patients with acquired immunodeficiency syndrome (AIDS) complicated with thoracic tuberculosis (TB), and to investigate the correlation of the HRCT signs with CD4 + T lymphocyte level. Methods From January 2013 to December 2017, 235 patients who were pathological and laboratory confirmed or clinically diagnosed with AIDS complicated with thoracic TB in Beijing Ditan Hospital affiliated to Capital Medical University were selected as subjects. Data on HRCT signs and CD4 + T lymphocyte counts of each subject were collected. The CD4 + T lymphocyte levels of patients were graded to Ⅰ (<100×10 6/L) and Ⅱ (≥100×10 6/L). The correlation between the HRCT signs and different immunity levels was analyzed. Results The overall incidence of secondary pulmonary TB, hematogenous disseminated TB, and mediastinal lymph node TB were 66.8% (157/235), 31.9% (75/235), and 63.8% (150/235), respectively. For patients with grade Ⅰ and Ⅱ CD4 + T lymphocyte level, the incidence of mediastinal lymph node TB was 51.9% (122/235) and 11.9% (28/235), respectively. The difference was statistically significant (χ 2=3.59, P=0.048). In AIDS patients complicated with secondary pulmonary TB who had grade Ⅰ CD4 + T lymphocyte level, the occurrence rates of consolidation, consolidation and cavitation, and multiple cavitation in the HRCT scan were 55.4% (87/157), 17.2% (27/157), and 10.2% (16/157), which were higher than those of the patients having grade Ⅱ CD4 + T lymphocyte level (13.4% (21/157), 3.8% (6/157), and 1.9% (3/157)), respectively. The discrepancies were statistically significant (χ 2=6.47, 8.22, and 7.47; P=0.014, 0.004, and 0.045, respectively). The incidence of secondary pulmonary TB occurring in the anterior segment of the superior lobe, the right middle lobe, and the left segment of the tongue were higher in cases with grade Ⅰ CD4 + T lymphocyte level (26.1% (41/157), 24.2% (38/157), and 27.4% (43/157)) compared with cases with grade Ⅱ (5.7% (9/157), 3.2% (5/157), and 3.8% (6/157)). The differences were statistically significant (χ 2=0.78, 5.40, and 6.79; P=0.037, 0.045, and 0.039, respectively). Conclusion The thoracic TB complicated in AIDS patients are mainly secondary pulmonary TB and mediastinal lymph node TB. The HRCT signs are related to the degree of damage on the immune function of CD4 + T lymphocytes. The lower the CD4 + T lymphocyte count is, the more complex and untypical the chest HRCT signs are.

Key words: Acquired immunodeficiency syndrome, Tuberculosis, Comorbidity, Tomography, X-ray computed, T-lymphocyte subsets