肺结核患者肺间质性病变的HRCT征象特点及其影像学疗效的观察  

HRCT manifestations and imaging efficacy of pulmonary interstitial lesions in patients with pulmonary tuberculosis

作　　者：刘树荣 孙培培 侯学静 姜立杰 王强 LIU Shu-rong;SUN Pei-pei;HOU Xue-jing;JIANG Li-jie;WANG Qiang(Hengshui People’s Hospital,Hengshui,Hebei 053099,China)

机构地区：[1]衡水市人民医院,河北衡水053099

出　　处：《临床肺科杂志》2022年第9期1421-1424,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探究活动性肺结核间质病变HRCT特征及影像学疗效观察。方法选择2017年12月-2021年12月衡水市人民医院诊治的初次发病,活动性肺结核患者120例,根据HRCT征象有无间质病变分为两组,分析两组患者治疗前后肺间质病变吸收变化规律。结果存在肺结核间质病变患者(79例),HRCT主要表现为小叶内间质病变,包括小叶内细网格影(52例)、小叶内微结节(59例)及小叶间隔增厚(24例)。经规范治疗,不同类型病变均有不同程度吸收;治疗过程中,小叶内细网格和小叶间隔在强化期末和未治疗前比较,无明显差异(P>0.05),治疗结束和强化末期比较,也无明显差异(P>0.05),治疗末期和治疗前明显降低(P<0.05)。结论活动性肺结核间质病变包括小叶细网格影、小叶内微结节、小叶间隔增厚、支气管血管束增厚等较实质病变吸收时间明显滞后,在治疗过程中可以通过HRCT检查以评价临床治疗效果。Objective To explore the HRCT manifestations and imaging efficacy observation of active pulmonary tuberculosis interstitial lesions.Methods A total of 120 patients with active pulmonary tuberculosis with initial onset diagnosed and treated in Hengshui People's Hospital from December 2017 to December 2021 were selected and divided into two groups according to HRCT signs with or without interstitial lesions.The changes in the absorption of pulmonary interstitial lesions before and after treatment in the two groups were analyzed.Results In patients with pulmonary tuberculosis interstitial lesions(79 cases),HRCT mainly showed intralobular interstitial lesions,including intralobular fine grid shadows(52 cases),intralobular micronodules(59 cases),and interlobular septal thickening(24 cases).Different types of lesions have different degrees of absorption after standard treatment.During the treatment,there was no significant difference between the intralobular fine grid and the interlobular septum at the end of the enhancement phase and before the treatment(P>0.05),and there was no significant difference between the end of the treatment and the end of the enhancement phase(P>0.05).However,at the end of treatment,it was significantly lower than that before treatment(P<0.05).Conclusion Active pulmonary tuberculosis interstitial lesions,including lobular fine grid shadows,intralobular micronodules,thickened interlobular septa,and thickened bronchovascular bundles,have a significantly delayed absorption time compared with parenchymal lesions.HRCT can be used to evaluate clinical symptoms during the treatment.

关 键 词：活动性肺结核 肺间质病变 HRCT 

分 类 号：R521[医药卫生—内科学]