影响初治继发性肺结核空洞闭合的相关因素分析  

Analysis of related factors influencing cavity closure of initial-treated secondary pulmonary tuberculosis

作　　者：户彦龙[1] 窦文广[1] 岳军艳[1] 王鹏铭 牛俊梅[2] 梁长华[1] HU Yan-long;DOU Wen-guang;YUE Jun-yan;WANG Peng-ming;NIU Jun-mei;LIANG Chang-hua(Department of Radiology,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henan453100,China;Department of Tuberculosis,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henan453100,China)

机构地区：[1]新乡医学院第一附属医院放射科,河南卫辉453100 [2]新乡医学院第一附属医院结核内科一病区,河南卫辉453100

出　　处：《临床肺科杂志》2022年第8期1143-1147,共5页Journal of Clinical Pulmonary Medicine

基　　金：河南省医学科技攻关计划联合共建项目(No.LHGJ20200520)。

摘　　要：目的探讨初治药物敏感继发性肺结核患者标准化治疗过程中结核空洞的转归及影响其治疗6个月仍未闭合的相关因素。方法纳入2018年1月至2021年4月初治空洞性肺结核119例,治疗前行胸部CT检查均合并直径≥10mm的结核空洞,对其治疗1、3、6个月进行随访,将患者治疗6个月时结核空洞是否闭合分为空洞未闭合组(39例)及空洞闭合组(80例)。应用单因素及多因素Logistic回归分析影响空洞闭合的危险因素。结果治疗前空洞未闭合组中≥40岁组58.8%(20/34)、发病时间>1个月组40.8%(29/71)、单发空洞组40.0%(34/85)、空洞直径>20mm组53.7%(22/41)的比例分别高于<40岁组22.4%(19/85)、发病时间≤1个月组20.8%(10/48)、多发空洞组14.7%(5/34)、空洞直径10~20mm组21.8%(17/78),单因素分析均有统计学差异(χ^(2)=14.661、5.205、7.052、12.384,P<0.05),Logistic回归分析显示此四项均可增加抗结核治疗6个月空洞未闭合的风险(P<0.05)。结论年龄、发病时间、空洞数量及空洞直径均是影响肺结核空洞闭合的重要因素。Objective To investigate the outcome of tuberculosis cavity during standardized treatment of initial-treated drug-sensitive secondary pulmonary tuberculosis patients and the related factors affecting its failure to close after 6-months treatment.Methods 119 cases of cavity tuberculosis were included from January 2018 to April 2021.Before treatment,the chest computed tomography(CT)examination showed that there were tuberculosis cavities≥10mm in diameter,and follow-up after 1,3,and 6 months of treatment.The patients were divided into the unclosed group(39 cases)and the closed group(80 cases)whether the tuberculous cavity was closed after 6-month treatment.Univariate analysis and multivariate logistic analysis were adopted to analyze the risk factors of cavity closure.Results Before treatment,the proportions of unclosed patients≥40 years old(58.8%,20/34),onset time>1 month(40.8%,29/71),single cavity(40.0%,34/85),and cavity diameter>20mm(53.7%,22/41)were higher than those<40 years old(22.4%,19/85),onset time≤1 month(20.8%,10/48),multiple cavity(14.7%,5/34),cavity diameter 10~20mm(21.8%,17/78),respectively.Univariate analysis was statistically different(χ^(2)=14.661,5.205,7.052,12.384,P<0.05).Logistic regression analysis showed that these four factors could increase the risk of unclosed cavity after 6 months of anti-tuberculosis treatment(P<0.05).Conclusion Age,onset time,cavity number and cavity diameter are important factors affecting the closure of pulmonary tuberculosis cavities.

关 键 词：结核 肺 空洞 计算机断层成像 治疗转归 

分 类 号：R521[医药卫生—内科学]