肺结核病灶进展的CT表现及临床特点分析

doi:10.19871/j.cnki.xfcrbzz.2021.01.012

新发传染病电子杂志 ›› 2021, Vol. 6 ›› Issue (1): 54-57.doi: 10.19871/j.cnki.xfcrbzz.2021.01.012

肺结核病灶进展的CT表现及临床特点分析

朱怡¹, 任砚¹, 程晰¹, 刘荣荣¹, 刘静¹, 唐佩军², 李敏¹

1.苏州大学附属传染病医院,苏州市第五人民医院放射科,江苏苏州 215131;
2.苏州大学附属传染病医院,苏州市第五人民医院结核病科,江苏苏州 215131

收稿日期:2020-04-08 出版日期:2021-02-28 发布日期:2021-03-03
通讯作者: 李敏,E-mail:105549156@qq.com
基金资助:
江苏省2017年“科教兴卫”青年科技项目（KJXW2017047）

CT findings and clinical characteristics of pulmonary tuberculosis with increased lesions

Zhu Yi¹, Ren Yan¹, Cheng Xi¹, Liu Rongrong¹, Liu Jing¹, Tang PeiJun², Li Min¹

1. Department of Radiology, The Affiliated Infectious Diseases Hospital of Soochow University, the Fifth People's Hospital of Suzhou, Jiangsu Suzhou 215131, China;
2. Department of Tuberculosis, the Affiliated Infectious Diseases Hospital of Soochow University, the Fifth People's Hospital of Suzhou, Jiangsu Suzhou 215131, China

Received:2020-04-08 Online:2021-02-28 Published:2021-03-03

摘要/Abstract

摘要： 目的分析抗结核治疗后出现病灶进展患者的CT影像学及其临床特点。方法收集苏州市第五人民医院于2015年12月至2018年12月收治的抗结核治疗后病灶增多患者48例,对上述患者进展前及进展后病灶的CT影像学及其临床资料进行回顾性分析与总结。结果 48例患者中,CT上增多病灶的分布以与进展前病灶同肺段者46例（95.83%）最多,与进展前病灶跨段同叶分布者14例（29.17%）次之;病灶增多的量以中等量增多者29例（60.42%）最多,少量增多者17例（35.42%）次之;进展病灶的CT征象主要为斑片影37例（77.08%）、结节26例（54.17%）、树芽征22例（45.83%）、实变影20例（41.67%）、磨玻璃影13例（27.08%）。病灶进展前后比较中,结节、树芽征、空洞、局限性肺气肿、钙化、条索灶的差异有统计学意义（χ²=11.35、11.51、13.85、9.04、21.26和51.40,P均<0.05）。病灶进展期间临床表现主要为咳嗽40例（83.33%）、咳痰33例（68.75%）、发热12例（25.00%）;实验室检查阳性或异常指标如下：痰找抗酸杆菌阳性10例（20.83%）,痰培养结核杆菌10例（20.83%）,耐药6例（12.50%）,白细胞计数减少7例（14.58%）,真菌检测6例（12.50%）。结论肺结核治疗中进展的病灶与进展前病灶分布关系紧密,进展的病灶以活动性肺结核CT征象为主,临床表现以咳嗽、咳痰为主,需要进行相关病原学检查,结合CT表现可以为临床治疗方案调整提供帮助。

关键词: 结核, 肺, X线计算机, 体层摄影术

Abstract: Objective To analysis the CT signs and clinical features of increased lesions during the treatment of pulmonary tuberculosis. Methods Forty-eight pulmonary tuberculosis patients with increased focus admitted to the Suzhou Fifth People's Hospital from December 2015 to December 2018 were collected, and the CT imaging and clinical data of the pre progression lesions and post-progression lesions of the above patients were retrospectively analyzed and summarized. Results Of the 48 patients, 46(95.83%) patients had increased lesions in the same lung segment as the pre progression lesion, 14(29.17%) patients had increased lesions in the same lobe as the pre progression lesion.29(60.42%) patients increased in medium amount, and 17(35.42%) patients increased in small amount. The main CT signs of increased lesions were patch shadow in 37 cases (77.08%), nodule in 26 cases (54.17%), tree-in-bud sign in 22 cases (45.83%), consolidation shadow in 20 cases (41.67%), ground glass opacity in 13 cases (27.08%). There were statistically significant differences in nodule, tree-in-bud sign, cavity, localized emphysema, calcification and cord focus before and after the lesion progression (χ²=11.35、11.51、13.85、9.04、21.26、51.4,P<0.05). During the period of increased lesions, the main clinical symptoms were cough in 40(83.33%) patients, expectoration in 33(68.75%) patients and fever in 12(25.00%) patients. The positive or abnormal indexes of laboratory test were as follows: 10(20.83%) patients of acid fast bacilli, 10(20.83%) patients of Mycobacterium tuberculosis, 6(12.50%) patients of drug resistance, 7(14.58%) patients of decreased leukocyte index and 6(12.50%) patients of fungus detection. Conclusion In the treatment of pulmonary tuberculosis, the increased lesions is closely related to the distribution of the pre progression lesions, and the increased lesions morphology is mainly CT signs of active pulmonary tuberculosis; the clinical manifestations are mainly cough and expectoration, it is need to carry out relevant etiological examination, combined with CT imaging, which can provide help for the adjustment of the clinical treatment plan.

Key words: Tuberculosis, Lung, X-ray computer, tomography

朱怡, 任砚, 程晰, 刘荣荣, 刘静, 唐佩军, 李敏. 肺结核病灶进展的CT表现及临床特点分析[J]. 新发传染病电子杂志, 2021, 6(1): 54-57.

Zhu Yi, Ren Yan, Cheng Xi, Liu Rongrong, Liu Jing, Tang PeiJun, Li Min. CT findings and clinical characteristics of pulmonary tuberculosis with increased lesions[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(1): 54-57.

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肺结核病灶进展的CT表现及临床特点分析

CT findings and clinical characteristics of pulmonary tuberculosis with increased lesions

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