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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ldt</journal-id><journal-title-group><journal-title xml:lang="ru">Лучевая диагностика и терапия</journal-title><trans-title-group xml:lang="en"><trans-title>Diagnostic radiology and radiotherapy</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-5343</issn><publisher><publisher-name>Baltic Medical Education Center</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.22328/2079-5343-2019-10-4-14-19</article-id><article-id custom-type="elpub" pub-id-type="custom">ldt-450</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ И ЛЕКЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS AND LECTURES</subject></subj-group></article-categories><title-group><article-title>Роль компьютерной томографии в раннем выявлении туберкулеза органов дыхания, в том числе у лиц, живущих с ВИЧ-инфекцией</article-title><trans-title-group xml:lang="en"><trans-title>The role of computer tomography in early identification of tuberculosis of respiratory bodies, including in persons living with HIV infection</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0674-6869</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мастерова</surname><given-names>И. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Masterova</surname><given-names>I. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мастерова Ирина Юрьевна — аспирант НИИ фтизиопульмонологии — специальность клиническая медицина (лучевая диагностика, лучевая терапия, фтизиатрия), врач-фтизиатр туберкулезного легочного отделения № 1 филиала «Туберкулезная больница № 1» ФКУЗ «Медико-санитарная часть № 78» Федеральной службы исполнения наказаний России, SPIN-код 1869-0517.</p><p>188508, Ленинградская область, Ломоносовский район, Виллозское городское поселение, ул. Заречная, д. 22</p></bio><bio xml:lang="en"/><email xlink:type="simple">imast3_02@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8836-4447</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дегтярева</surname><given-names>С. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Degtyareva</surname><given-names>S. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дегтярева Светлана Юрьевна — ассистент кафедры инфекционных болезней с курсами эпидемиологии и фтизиатрии, SPIN-код 6025-3746.</p></bio><bio xml:lang="en"><p>Svetlana Yu. Degtyareva</p><p>Moscow</p></bio><email xlink:type="simple">degtyareva_svet@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1489-5058</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Наркевич</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Narkevich</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Наркевич Артем Николаевич — кандидат медицинских наук, заведующий научно-исследовательской лабораторией «Медицинской кибернетики и управления в здравоохранении», доцент кафедры медицинской кибернетики и информатики КрасГМУ им. проф. В. Ф. Войно-Ясенецкого; SPIN-код 9030-1493.</p><p>660022, Красноярский край, Красноярск, ул. Партизана Железняка, д. 1</p></bio><bio xml:lang="en"/><email xlink:type="simple">narkevichart@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8211-4268</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шлыкова</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shlykova</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шлыкова Людмила Аркадьевна — начальник медицинской части, врач-фтизиатр филиала Туберкулезная больница № 1 ФКУЗ МСЧ № 78» Федеральной службы исполнения наказаний России, SPIN-код 7293-5888.</p><p>188508, Ленинградская область, Ломоносовский район, Виллозское городское поселение, ул. Заречная, д. 22</p></bio><bio xml:lang="en"/><email xlink:type="simple">luar56@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8736-7304</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зайцева</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zaitseva</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зайцева Елена Валерьевна — кандидат медицинских наук, врач-фтизиатр туберкулезного легочно-хирургического (торакального) отделения № 3, SPIN-код 7636-1088.</p><p>191036, Санкт-Петербург, Лиговский пр., д. 2-4</p></bio><bio xml:lang="en"/><email xlink:type="simple">e.v.zaiceva@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3251-4084</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гаврилов</surname><given-names>П. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gavrilov</surname><given-names>P. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гаврилов Павел Владимирович — кандидат медицинских наук, ведущий научный сотрудник, руководитель направления «Лучевая диагностика» СПбНИИФ; доцент научно-клинического и образовательного центра «Лучевая диагностика и ядерная медицина» Института высоких медицинских технологий СПбГУ , SPIN-код 7824-5374.</p><p>191036, Санкт-Петербург, Лиговский пр., д. 2-4</p></bio><bio xml:lang="en"/><email xlink:type="simple">spbniifrentgen@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Санкт-Петербургский НИИ фтизиопульмонологии МЗ РФ; Медико-санитарная часть № 78 ФСИН России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>St. Petersburg Research Institute of Phthisiopulmonology of the Ministry of Health of the Russian Federation; Medical Sanitary Unit No. 78 of the Federal Penitentiary Service of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Российский университет дружбы народов</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Peoples’ Friendship University of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Krasnoyarsk State Medical University named after Prof. V. F. Voino-Yasenetsky</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Медико-санитарная часть № 78 ФСИН России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Medical Sanitary Unit No. 78 of the Federal Penitentiary Service of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Санкт-Петербургский НИИ фтизиопульмонологии МЗ РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>St. Petersburg Research Institute of Phthisiopulmonology of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>07</day><month>02</month><year>2020</year></pub-date><volume>0</volume><issue>4</issue><fpage>14</fpage><lpage>19</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мастерова И.Ю., Дегтярева С.Ю., Наркевич А.Н., Шлыкова Л.А., Зайцева Е.В., Гаврилов П.В., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Мастерова И.Ю., Дегтярева С.Ю., Наркевич А.Н., Шлыкова Л.А., Зайцева Е.В., Гаврилов П.В.</copyright-holder><copyright-holder xml:lang="en">Masterova I.Y., Degtyareva S.Y., Narkevich A.N., Shlykova L.A., Zaitseva E.V., Gavrilov P.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://radiag.bmoc-spb.ru/jour/article/view/450">https://radiag.bmoc-spb.ru/jour/article/view/450</self-uri><abstract><p>В настоящее время в мире и в РФ отмечается снижение темпов роста случаев ВИЧ-инфицирования и туберкулеза, однако отмечается ежегодное возрастание доли случаев сочетания данных инфекций. Методом лучевого скрининга в РФ признана флюорография, которая выявляет не более половины пациентов ВИЧ/ТБ, а применение такого чувствительного метода, как компьютерная томография (КТ), носит только рекомендательный характер. ВОЗ рекомендует использования лучевой диагностики в качестве инструмента скрининга только при распространенности данного сочетания инфекций более 20%.</p><p>В настоящее время доказано, что ВИЧ-инфицированные пациенты не менее чем в 20 чаще болеют туберкулезом, причем при нарастании иммунодефицита у них формируются патоморфологические характеристики первичного туберкулеза органов дыхания, при этом наблюдается быстрое прогрессирование как ВИЧ-инфекции, так и туберкулеза, часто приводящее к гибели пациентов. Также изменяются патоморфологические характеристики, регистрируемые при компьютерной томографии. Представлен обзор исследований, посвященных возможностям выявления туберкулеза органов дыхания при компьютерной томографии в том числе у лиц, живущих с ВИЧ-инфекцией (n=24). Для сравнения эффективности КТ использовано разделение по скиалогическим синдромам и степени угнетения иммунитета. Рассмотрена частота встречаемости компьютернотомографических паттернов у данной группы и выяснено, что КТ является также наиболее чувствительным методом диагностики туберкулеза у ВИЧ-позитивных лиц. Повышение эффективности выявления возможно при анализе жалоб пациентов и степени выраженности иммуносупрессии. Таким образом, КТ органов грудной полости может быть использована на этапе скрининга туберкулеза органов дыхания у ВИЧ-инфицированных пациентов с учетом уровня CD4+-лимфоцитов.</p></abstract><trans-abstract xml:lang="en"><p>Currently, in the world and in the Russian Federation there has been a decrease in the growth rate of cases of HIV infection and tuberculosis, however, an annual increase in the proportion of cases of a combination of these infections is noted. The method of radiation screening in the Russian Federation recognized fluorography, which reveals no more than half of HIV/TB patients, and the use of such a sensitive method as CT is only advisory in nature. WHO recommends the use of radiation diagnostics as a screening tool only if the prevalence of this combination of infections is more than 20%. Currently, it has been proven that HIV infected patients suffer from tuberculosis at least 20 more often, and with an increase in immunodeficiency, they form pathomor-phological characteristics of primary respiratory tuberculosis, while there is a rapid progression of both HIV infection and tuberculosis, often leading to death of patients. The pathomorphological characteristics recorded during computed tomography also change. A review of studies on the possibilities of detecting respiratory tuberculosis in computed tomography, including in people living with HIV infection (n=24), is presented. To compare the effectiveness of CT, a separation was used according to the psychological syndromes and the degree of suppression of immunity. The frequency of occurrence of computed tomographic patterns in this group was examined and it was found that CT is also the most sensitive method for diagnosing tuberculosis in HIV-positive individuals. And increasing the effectiveness of detection is possible when analyzing patient complaints and the severity of immunosuppression. Thus, computed tomography of the organs of the chest cavity can be used at the stage of screening for respiratory tuberculosis in HIV infected patients, taking into account the level of CD4+ lymphocytes.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>туберкулез органов дыхания</kwd><kwd>ВИЧ-инфекция</kwd><kwd>компьютерная томография органов грудной полости</kwd></kwd-group><kwd-group xml:lang="en"><kwd>respiratory tuberculosis</kwd><kwd>HIV infection</kwd><kwd>computed tomography of the chest cavity</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Gilpin C., Korobitsyn A., Migliori G.B., Raviglione M.C., Weyer K. The World Health Organization standards or tuberculosis care and management /// Eur. Respir. J. 2018. Mar 22. 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