人类免疫缺陷病毒感染者的间质性肺病

Q4 Medicine
Elena V. Korzh
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引用次数: 0

摘要

对人类免疫缺陷病毒(HIV)感染者间质性肺病(ILD)的诊断仍然知之甚少。这项工作的目的是展示对不同CD4淋巴细胞水平的HIV感染者进行ILD诊断的方法。本文分析了CD4淋巴细胞数分别为677(37.5%)和1(0.21%)个/μl的HIV感染者(n = 2)的ILD文献数据和临床观察结果。肺科专家对患者进行了长期观察和治疗,包括抗结核化疗。CD4 淋巴细胞计数为 677 cells/μl、痰中无结核分枝杆菌的患者被确诊为特发性肺纤维化,呼吸衰竭呈进行性发展,计算机断层扫描图在 2 年内从大面积 "磨玻璃 "发展到形成网状变化和 "蜂窝状 "肺。该患者的 CD4 细胞数为 1 个/μl,根据其在无细菌排泄的弥漫性间质性肺纤维化背景下呼吸衰竭加重的特征性临床表现,以及 7 个月的抗霉菌、抗菌和抗真菌治疗效果,并排除其他肺损伤原因,诊断为非特异性间质性肺炎。艾滋病病毒感染者在不同的 T 辅助免疫状态下会出现非感染性的肺间质纤维化过程。在排除了机会性感染、其他因素和并发症的影响后,这些患者被诊断为各种形式的特发性间质性肺炎。然而,现有关于病毒对肺实质直接破坏作用的报告也表明,可能存在与艾滋病毒相关的间质性肺纤维化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Interstitial lung diseases in persons infected with human immunodeficiency virus
Diagnosis of interstitial lung diseases (ILD) in individuals infected with the human immunodeficiency virus (HIV) remains poorly understood.The purpose of the work was to demonstrate approaches to the diagnosis of ILD in HIV-infected patients with different levels of CD4 lymphocytes. An analysis of literature data and clinical observations of ILD in HIV-infected individuals (n = 2) whose CD4 lymphocyte count was 677 (37.5%) and 1 (0.21%) cells/μl are presented. The patients were observed and treated for a long time by pulmonology specialists, including anti-tuberculosis chemotherapy. The patient with CD4 lymphocyte count of 677 cells/μl in the absence of Mycobacterium tuberculosis in the sputum had an established diagnosis of idiopathic pulmonary fibrosis with the progressive development of respiratory failure and progression of the computed tomographic pattern from large areas of “ground glass” to the formation of reticular changes and “honeycomb” lung within 2 years. The patient with CD4 count of 1 cell/μl was diagnosed with nonspecific interstitial pneumonia based on characteristic clinical manifestations of increasing respiratory failure against the background of diffuse interstitial pneumofibrosis in the absence of bacterial excretion, the effects of antimycobacterial, antibacterial and antifungal treatment for 7 months, and excluding other causes of lung damage.Conclusion. The development of interstitial fibrosing pulmonary process of non-infectious etiology in HIV-infected patients with different states of T-helper immunity has been demonstrated. After excluding opportunistic infections, the influence of other factors, and concomitant diseases, these patients were diagnosed with various forms of idiopathic interstitial pneumonia. However, existing reports of the direct damaging effects of the virus on the pulmonary parenchyma also suggest the possibility of HIV-associated interstitial pulmonary fibrosis.
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来源期刊
Pulmonologiya
Pulmonologiya Medicine-Pulmonary and Respiratory Medicine
CiteScore
1.40
自引率
0.00%
发文量
70
期刊介绍: The aim of this journal is to state a scientific position of the Russian Respiratory Society (RRS) on diagnosis and treatment of respiratory diseases based on recent evidence-based clinical trial publications and international consensuses. The most important tasks of the journal are: -improvement proficiency qualifications of respiratory specialists; -education in pulmonology; -prompt publication of original studies on diagnosis and treatment of respiratory diseases; -sharing clinical experience and information about pulmonology service organization in different regions of Russia; -information on current protocols, standards and recommendations of international respiratory societies; -discussion and consequent publication Russian consensus documents and announcement of RRS activities; -publication and comments of regulatory documents of Russian Ministry of Health; -historical review of Russian pulmonology development. The scientific concept of the journal includes publication of current evidence-based studies on respiratory medicine and their discussion with the participation of Russian and foreign experts and development of national consensus documents on respiratory medicine. Russian and foreign respiratory specialists including pneumologists, TB specialists, thoracic surgeons, allergists, clinical immunologists, pediatricians, oncologists, physiologists, and therapeutists are invited to publish article in the journal.
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