AIDS合并马尔尼菲篮状菌病患者胸部CT表现与CD4+T淋巴细胞计数的关系OA
The correlation between chest CT manifestations and CD4+T lymphocyte count in AIDS patients with Talaromycosis
目的 分析AIDS合并马尔尼菲篮状菌病(Talaromycosis,TSM)患者的胸部CT表现、肺部病变分布及病变严重程度与CD4+T淋巴细胞计数的关系,探讨其影像学特点与免疫状态的相关性.方法 回顾性分析上海市公共卫生临床中心2015年1月至2024年12月收治的122例AIDS合并TSM患者的临床资料、胸部CT表现和CD4+T淋巴细胞计数.分析CT影像表现、肺部病变分布特征与CD4+T淋巴细胞计数的关系以及肺部病变累及的肺段数、肺部病变的CT评分与CD4+T淋巴细胞计数的相关性.结果 TSM患者的胸部CT表现具有多样性,主要为粟粒结节、结节、磨玻璃影或斑片影、纵隔淋巴结肿大.根据CT表现进行分组比较,粟粒结节组与无粟粒结节组、纵隔淋巴结肿大组与无纵隔淋巴结肿大组、肺部有病变组与肺部无病变组,CD4+T淋巴细胞计数的差异无统计学意义(P＞0.05).根据肺部病变分布情况进行分组比较,肺部病变两肺分布组与非两肺分布组、肺部病变弥漫性分布组与非弥漫性分布组,CD4+T淋巴细胞计数的差异无统计学意义(P＞0.05).肺部病变累及的肺段数、肺部病变的CT评分与CD4+T淋巴细胞计数无显著的相关性(P＞0.05).结论 AIDS合并TM感染患者肺部CT表现(包括病变形态、分布范围)及其严重程度均与CD4+T淋巴细胞计数无显著相关性.结果 提示,TM感染所致的肺部影像学特征可能独立于宿主免疫抑制程度,这为进一步理解该疾病的病理机制提供了新的视角.
Objective To explore the relationship between the count of CD4+T lymphocyte and the chest CT features including manifestation,distributions of pulmonary lesion,as well as the severity of pulmonary lesion in AIDS patients with Talaromycosis(TSM).Method A retrospective analysis was performed on the clinical data,chest CT findings and CD4+T lymphocyte counts of 122 patients with AIDS complicated by TSM who were admitted to Shanghai Public Health Clinical Center from January 2015 to December 2024.The relationships between CT imaging manifestations/distribution characteristics of pulmonary lesions and CD4+T lymphocyte counts were investigated.The correlations between the number of affected pulmonary segments/CT severity scores and CD4+T lymphocyte counts were analyzed.Result The chest CT manifestations of AIDS patients with TSM were diverse,mainly including miliary nodule,nodule,ground-glass opacity or patchy shadow,and mediastinal lymphadenopathy.There were no significant differences in CD4+T lymphocyte count among groups with different chest CT manifestations(P＞0.05),including between groups with miliary nodule and those without,groups with mediastinal lymphadenopathy and those without,and groups with pulmonary lesion and those without.There were no significant differences in CD4+T lymphocyte count among groups with different distributions of pulmonary lesion(P＞0.05),including between groups with bilateral distribution and non-bilateral distribution,and between groups with diffuse distribution and non-diffuse distribution.The number of lung segment involved by pulmonary lesion and the CT score of pulmonary lesion showed no significant correlation with CD4+T lymphocyte count(P＞0.05).Conclusion This study demonstrates that the pulmonary CT manifestations(including lesion morphology and distribution)and their severity in AIDS patients with Talaromyces marneffei infection show no significant correlation with CD4+T lymphocyte counts.These findings suggest that the imaging characteristics of Talaromyces marneffei infection may be independent of the degree of host immunosuppression,providing a new perspective for understanding the pathogenesis of this disease.
石秀东;丁晨寒;杨影;宋朋睿;施裕新
上海市公共卫生临床中心放射科,上海 201508上海市公共卫生临床中心放射科,上海 201508上海市公共卫生临床中心放射科,上海 201508上海市公共卫生临床中心放射科,上海 201508上海市公共卫生临床中心放射科,上海 201508
医药卫生
获得性免疫缺陷综合征马尔尼菲篮状菌CD4+T淋巴细胞体层摄影术
Acquired immune deficiency syndromeTalaromyces marneffeiCD4+T lymphocyteTomography
《新发传染病电子杂志》 2026 (1)
55-59,5
1.国家自然科学基金(82302265)2.上海市公共卫生临床中心院内课题(RCJJ-2025-07)
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