目的:探讨海洛因依赖者合并肺结核的影像学表现特征,以提高对该人群肺结核的X线影像学的认识及诊断水平。方法:收集和分析2001年1月-2006年6月间我中心收治的30例海洛因依赖患者合并肺结核的影像学资料。30例均行X线正侧位胸片检查,其中6例同时加行CT检查。结果:30例肺结核中浸润型(Ⅲ型)肺结核23例(76.7%),结核性胸膜炎(Ⅴ型)3例(10%),原发型肺结核(Ⅰ型)2例(6.7%),血行播散型肺结核(Ⅱ型)1例(3.3%),慢性纤维空洞型肺结核(Ⅳ)1例(3.3%)。病变多为大片状﹑斑片状或小片状渗出实变阴影,其中伴有/或无小结节﹑空洞﹑肺门和/或纵隔淋巴结肿大等病灶混杂存在,边界模糊,呈双肺多叶多段受累,病灶多有融合趋势。结论:海洛因依赖合并肺结核后,各型肺结核均可见(Ⅲ型最多),X线表现以多种性质的病灶共存,多形态,多叶﹑段分布,病变广泛,肺毁损严重,胸膜炎以渗出性为主,表现为中或少量积液,干性胸膜炎表现为胸膜肥厚和粘连。 Objective: To investigate the imaging features of pulmonary tuberculosis in heroin dependent patients so as to improve the understanding and diagnosis of pulmonary tuberculosis in this population. Methods: Thirty cases of heroin dependent pulmonary tuberculosis were collected and analyzed from January 2001 to June 2006 in our center. 30 cases were performed X-ray positive lateral chest X-ray examination, including 6 cases at the same time plus line CT examination. Results: Twenty-three cases (76.7%) of tuberculous infiltrative (type III) tuberculosis, three (10%) cases of tuberculous pleurisy (type Ⅴ), two cases of primary pulmonary tuberculosis One case (3.3%) of disseminated pulmonary tuberculosis (type II) and one case (3.3%) of chronic fibrous hollow tuberculosis (Ⅳ). Lesions mostly large ﹑ patchy patchy or exudate consolidation shadow, which with / without nodules, hollows, hilar and / or mediastinal lymph nodes and other lesions mixed, fuzzy boundaries, was Multi-leaf lung involvement, multi-fusion trend. CONCLUSIONS: Heroin-dependent pulmonary tuberculosis can be seen in all types of pulmonary tuberculosis (most of type Ⅲ). X-ray manifestations coexist in many kinds of lesions. Morphology, multi-lobe distribution, extensive lesions, severe lung damage, and pleuritis exudate Sex-based, manifested as small or medium effusion, pleural effusion showed pleural thickening and adhesions.