目的 观察人类免疫缺陷病毒（HIV）感染相关性肺动脉高压（PAH）患者肺动脉管径特征，研究肺动脉管径相关指标联合肿瘤坏死因子-α（TNF-α），筛查诊断HIV相关肺动脉高压的临床价值，为临床提供参考。 方法 选取65例HIV感染患者为研究对象进行回顾性分析，根据超声心动图检查是否合并肺动脉高压分为观察组（23例，存在 PAH）和对照组（42例，无 PAH）。测量两组患者肺动脉内径（PA）、肺动脉直径（dPA）及主动脉直径，并计算dPA与主动脉直径比值（rPA），记录血清TNF-α水平，分析各指标在早期筛查诊断HIV相关肺动脉高压的临床价值。 结果 观察组患者PA、dPA、dPA与主动脉直径比值（rPA）以及TNF-α水平显著高于对照组。Pearson线性相关分析显示，TNF-α与dPA及rPA呈显著正相关。二列相关分析显示，HIV-PAH与PA、dPA、rPA及TNF-α显著相关（P < 0.05）。血清TNF-α与dPA及rPA联合检测诊断HIV-PAH的曲线下面积（AUC）为0.891，敏感度为0.870，特异度为0.881。 结论 肺动脉管径组合指标联合TNF-α能更好地提示HIV-PAH的存在，可以对高风险患者进行早期筛查，对高危人群进行随访或干预，这对改善患者预后具有重要意义。

Objective To investigate the characteristics of pulmonary artery diameter in patients with human immunodeficiency virus （HIV） infection-associated pulmonary hypertension （PAH）， and to explore the clinical significance of pulmonary artery diameter correlation indices combined with tumor necrosis factor-α （TNF-α） for early screening and diagnosis of HIV-associated pulmonary hypertension， aiming to provide valuable clinical insights. Methods A retrospective analysis was conducted on 65 HIV-infected patients admitted to the Eighth Hospital Affiliated to Guangzhou Medical University between May 2017 and December 2023. Based on echocardiography findings， the patients were categorized into an observation group （23 cases with PAH） and a control group （42 cases without PAH）. Measurements of pulmonary artery diameter （PA）， distal pulmonary artery diameter （dPA）， and aortic diameter were obtained in both groups， and the ratio of dPA to aortic diameter （rPA） was calculated. Additionally， serum TNF-α levels were recorded. The clinical significance of each index in early screening and diagnosis of HIV-related pulmonary hypertension was analyzed. Results The PA， dPA， rPA， and TNF-α levels in the observation group were significantly higher compared to those in the control group. Pearson linear correlation analysis revealed a significant positive correlation between TNF-α and both dPA and rPA. Two-column correlation analysis demonstrated a significant association between HIV-PAH and PA， dPA， rPA， as well as TNF-α （P < 0.05）. The combined measurement of serum TNF-α with dPA and rPA exhibited an area under the curve （AUC） of 0.891 for diagnosing HIV-APAH， with a sensitivity of 0.870 and specificity of 0.881. Conclusion The combination of pulmonary artery diameter and TNF-α provides a more accurate indication of the presence of HIV-PAH， enabling early screening， follow-up， or intervention in high-risk patients. This finding holds significant implications for enhancing patient prognosis.