肺结核合并下呼吸道感染患者CT影像特点及IL-23R水平表达的临床意义  

Clinical Significance of CT Features and IL-23R Expression in Patients with Pulmonary Tuberculosis Complicated with Lower Respiratory Tract Infection

作　　者：刘源 郭义平 李生中 罗国炷 董璇 LIU Yuan;GUO Yi-ping;LI Sheng-zhong;LUO Guo-zhu;Dong Xuan(Department of Tuberculosis,Wuhan Jinyintan Hospital,Wuhan,Hubei,430023,China)

机构地区：[1]武汉市金银潭医院结核科,湖北武汉430023

出　　处：《现代生物医学进展》2021年第18期3574-3578,共5页Progress in Modern Biomedicine

基　　金：湖北省卫生健康委科研项目(WJ2015MB166)。

摘　　要：目的:探讨肺结核合并下呼吸道感染患者CT影像特点及IL-23R水平表达的临床意义。方法:选取2015年1月-2018年8月于我院就诊的123例肺结核患者,将所选取的患者按是否合并下呼吸道感染分为单纯肺结核组73例和肺结核合并下呼吸道感染组50例。分析两组组患者临床表现、CT影像学图片、CT影像学表现、血清IL-23R的表达水平的差异。结果:单纯肺结核组患者出现14例低热、11例胸闷、17例消瘦、14例气短、18例痰中带血、14例颈部淋巴结肿大、23例咳嗽、21例胸痛。肺结核合并下呼吸道感染组患者出现16例低热、13例胸闷、21例消瘦、19例气短、20例痰中带血、15例颈部淋巴结肿大、26例咳嗽、23例胸痛,两组患者临床表现差异均无统计学意义(P>0.05)。单纯肺结核组CT影像学图片显示可见结节影或包块影,呈明显分叶征、短毛刺征、空泡征并发肺不张、棘状突起,边缘较清晰,增强扫描后明显强化。肺结核合并下呼吸道感染组CT影像学图片显示有分叶、毛刺,同时肺内肿物周边存在晕征、血管聚集征、卫星灶征、胸膜凹陷等表现,此外伴纵膈及肺门淋巴结明显肿大,胸壁侵犯。肺结核合并下呼吸道感染组CT影像中毛刺状结节、胸膜凹陷、空洞、分叶征、肿块、条索影比例均高于单纯肺结核组,差异有统计学意义(P<0.05)。肺结核合并下呼吸道感染组患者IL-23R水平明显高于单纯肺结核组,差异有统计学意义(P<0.05)。结论:与单纯肺结核患者相比较,肺结核合并下呼吸道感染患者临床表现更为严重,CT影像学特点更为明显,患者血清中IL-23R表达水平明显升高,临床可通过CT影像学结合血清IL-23R检测,以提高肺结核合并下呼吸道感染患者的临床诊断。Objective:To investigate the clinical significance of CT imaging features and IL-23 R expression in patients with pulmonary tuberculosis complicated with lower respiratory tract infection.Methods:123 patients with pulmonary tuberculosis in our hospital from January 2015 to August 2018 were selected and divided into simple pulmonary tuberculosis group(73 cases)and pulmonary tuberculosis combined with lower respiratory tract infection group(50 cases)according to whether they were complicated with lower respiratory tract infection.The differences of clinical manifestations,CT imaging pictures,CT imaging manifestations and serum IL-23 R expression between the two groups were analyzed.Results:There were 14 cases of low fever,11 cases of chest tightness,17 cases of emaciation,14 cases of shortness of breath,18 cases of blood in sputum,14 cases of cervical lymph node enlargement,23 cases of cough,21 cases of chest pain in the simple tuberculosis group.There were 16 cases of low fever,13 cases of chest tightness,21 cases of emaciation,19 cases of shortness of breath,20 cases of blood in sputum,15 cases of cervical lymph node enlargement,26 cases of cough,23 cases of chest pain in the tuberculosis combined with lower respiratory tract infection group.There were no significant differences in clinical manifestations between the two groups(P>0.05).CT images of simple pulmonary tuberculosis group showed nodule or mass shadow,showing obvious lobulation sign,short hairpin sign,vacuole sign,atelectasis,spinous process,clear edge,and obvious enhancement after enhanced scanning.CT images of pulmonary tuberculosis complicated with lower respiratory tract infection group showed lobulation,burr,halo sign,vascular aggregation sign,satellite focus sign,pleural depression and other manifestations around the lung tumor,in addition,mediastinum and hilar lymph node enlargement,chest wall invasion.The proportion of spiculated nodule,pleural indentation,cavity,lobulated sign,mass and stripe shadow in CT image of pulmonary tuberculosis combin

关 键 词：CT 肺结核 下呼吸道感染 IL-23R 临床意义 

分 类 号：R521[医药卫生—内科学] R814.42[医药卫生—临床医学]