珠海地区384例继发型肺结核临床及影像学表现  

Clinical and radiographic performances in 384 cases of secondary pulmonary tuberculosis in Zhuhai

作　　者：张洁[1] 陈许[2] 杜中立[1] 陈敏[1] 吴雪丽[1] 韩铭钧[3] 

机构地区：[1]珠海市人民医院放射影像科,广东珠海519000 [2]浙江省人民医院重症医学科,浙江杭州310014 [3]珠海市中山大学附属第五医院放射科,广东珠海519000

出　　处：《临床肺科杂志》2015年第9期1575-1579,共5页Journal of Clinical Pulmonary Medicine

基　　金：珠海市卫生局医学科研基金(No 2007052)

摘　　要：目的探讨继发型肺结核各类病变与年龄、发病时间、初治或复治之间的相互关系。方法收集继发型肺结核384例,统计分析渗出性病变、干酪性肺炎、结核球、空洞性病变与增殖性病变的发生率与发病年龄、发病时间和细菌学检查的关系。结果在不同年龄组中,各类病变的分布无统计学差异(χ2=14.916,P=0.061)。初治与复治组中,各类病变发生率的差异具有统计学意义(χ2=122.293,P=0.0001)。按从出现症状到CT检查的时间间隔,将327例新发病例分为急性组、亚急性组和慢性组。随着发病时间延长,渗出性病变、干酪性肺炎发生率下降、空洞性病变发生率上升,差异具有统计学意义(χ2=97.280,P=0.001)。各类病变的痰检阳性率具有显著差异(χ2=12.813,P=0.012)。结论随着发病时间延长,空洞性病变明显增多,渗出性病变和干酪性肺炎比例有所下降。Objective To discuss the relationship of the different kinds of pathological lesions of secondary tuberculosis to age, attack time, first treatment and re-treatment. Methods 384 patients with secondary pulmonary tuberculosis confirmed by pathology or clinical checks were reviewed. The different kinds of pathological lesions were observed through CT images, including exudative lesions, caseous pneumonia, tuberculoma, cavitation, and prolifer-ative lesions. The relationship between the patterns of lesions and the clinical factors such as their age, attack time, and the results of bacteriological examination were also analyzed. Results There was no significant difference in le-sion distribution among different age groups （χ2 = 14. 916, P = 0. 061）, but it showed certain differences between the first treated group and the re-treated group （χ2 = 122. 293, P = 0. 0001）. With the extension of disease time, the in-cidence of exudative lesions and caseous pneumonia decreased, and the incidence of cavitation increased （ χ2 =97. 280, P = 0. 001）. The sputum examination of different kinds of SPTB lesions was significantly different （χ2 =12. 813, P = 0. 012）. Conclusion The incidence of cavitation significantly increases with the extension of disease time, but the incidence of exudative lesions and caseous pneumonia decreases.

关 键 词：结核 肺 空洞 干酪性肺炎 结核球 体层摄影术 X 线计算机 

分 类 号：R521[医药卫生—内科学]