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目的提高对HIV所致肺动脉高压的认识,避免临床漏诊及误诊。方法选取青海大学附属医院2012-2015年HIV-抗体阳性且有胸部影像学资料的患者进行回顾性分析。根据内科学肺动脉高压X线征象标准及肺动脉分叉近端3cm范围内的最宽处主肺动脉横径MPAD>29mm判断具有肺动脉高压,计算我院HIV患者所致肺动脉高压的年发生率,根据出院诊断计算漏诊率,根据病历描述,分析HIV所致肺动脉高压可疑临床症状。结果HIV-抗体阳性47例,其中符合要求33例,右下肺动脉增宽并肺动脉段圆锥凸出高度≥3mm者1例,肺段动脉与支气管的外径比值>1再加MPAD>29mm者3例。本组HIV患者中出现相关HIV合并肺动脉高压的发生率12.1%,年发生率4.0%,漏诊率为75.0%。结论临床医师缺乏对HIV所致肺动脉高压的认识。
Objective To raise awareness of HIV-induced pulmonary hypertension and avoid clinical misdiagnosis and misdiagnosis. Methods We retrospectively analyzed the HIV-antibody-positive and chest imaging data from 2012 to 2015 in Affiliated Hospital of Qinghai University. The annual incidence of pulmonary hypertension was calculated according to the X-ray signs of internal medicine pulmonary hypertension and the widest MPAD> 29mm at the widest point within 3cm of the proximal end of the pulmonary artery bifurcation. According to the annual discharge rate of pulmonary hypertension caused by HIV patients in our hospital, Diagnosis Calculate the rate of misdiagnosis, according to medical records described, analysis of suspicious clinical symptoms of pulmonary hypertension caused by HIV. Results 47 cases were positive for HIV-antibody, of which 33 cases were eligible, 1 case had right lower pulmonary artery widening and conical protruding height of pulmonary artery segment≥3mm, 1 case had outer diameter ratio of pulmonary artery and bronchus> 1 plus MPAD> 29mm 3 example. The incidence of HIV-associated pulmonary hypertension in this group of HIV patients was 12.1%, with an annual incidence of 4.0% and a missed diagnosis rate of 75.0%. Conclusion Clinicians lack of awareness of pulmonary hypertension caused by HIV.