CT对耐多药肺结核患者治疗结果预测价值研究  

Predictive value of CT in the treatment of MDR-TB patients

作　　者：宋其生 郭晓红 张莉翎 李一鸣 路希维 SONG Qisheng;GUO Xiaohong;ZHANG Liling;LI Yiming;LU Xiwei(Department of Tuberculosis,Dalian Public Health Clinical Center,Dalian 116033,China;Department of Tuberculosis Liupanshui Third Hospital,Liupanshui 553541,China)

机构地区：[1]大连市公共卫生临床中心结核科,辽宁大连116033 [2]六盘水市第三人民医院结核科,贵州六盘水553541

出　　处：《大连医科大学学报》2021年第5期404-408,共5页Journal of Dalian Medical University

基　　金：贵州省科技计划项目([2020]4Y151)。

摘　　要：目的通过影像学六分区评分方法研究CT对于耐多药肺结核(MDR-TB)患者治疗结果的预测价值。方法搜集2018年1月至2020年12月期间六盘水市第三人民医院经痰结核菌培养证实并完成疗程的55例治愈和53例治疗失败的MDR-TB患者临床资料及肺CT影像学资料,比较这些患者之间临床特点及影像学差异性。应用受试者工作特征曲线(ROC曲线)统计方法分析MDR-TB患者治疗阳性预测值。结果通过ROC曲线分析发现,MDR-TB患者治疗12个月时敏感度与特异度分别为76.36%,77.36%,阳性预测值与阴性预测值分别为77.8%(95%CI:64.4%~88.0%)和75.9%(95%CI:62.4%~86.5%);曲线下面积(AUC)为0.835(95%CI:0.751~0.899)(P<0.05)。结论 CT对于MDR-TB患者治疗结果具有重要预测价值。Objective To study the predictive value of CT in the treatment of multidrug-resistant pulmonary tuberculosis(MDR-TB) by imaging score in six areas of lung. Methods The clinical data and pulmonary CT findings of 55 cured MDR-TB cases and 53 MDR-TB cases with treatment failure confirmed by sputum culture, who completed the course of treatment from January 2018 to December 2020 in Liupanshui Thrid Hospital, were collected. The clinical features and imaging differences between the two groups were compared. Receiver operating characteristic(ROC) analysis was used to analyze the positive predictive value of treatment outcome in MDR-TB patients. Results At 12 th month, the sensitivity and specificity of treatment outcome were 76.36% and 77.36% respectively, the positive predictive value and negative predictive value of treatment outcome were 77.8%(95%CI:64.4%-88.0%)and 75.9%(95%CI:62.4%-86.5%)respectively, and the area under ROC(AUC) was 0.835(95%CI:0.751-0.899)(P<0.05). Conclusion CT images are of great value in predicting the treatment outcome in MDR-TB patients.

关 键 词：CT MDR-TB ROC曲线分析 预测值 

分 类 号：R521[医药卫生—内科学]