鲍曼不动杆菌肺炎多种CT征象的多因素分析  

Multiple Factors Analysis of Multiple CT Signs of Acinetobacter Pneumonia in Bauman

作　　者：穆婧[1] 王军大 杨雅淋[1] 李艳艳[1] 张俊娜[3] MU Jing;WANG Jun-da;YANG Ya-lin;LI Yan-yan;ZHANG Jun-na(clinical pharmacy department of Chongqing hospital of traditional Chinese medicine,Chongqing 400021,China;radiology department of Chongqing hospital of traditional Chinese medicine,Chongqing 400021,China;Respiratory Department of Chongqing hospital of traditional Chinese medicine,Chongqing 400021,China)

机构地区：[1]重庆市中医院临床药学部,重庆400021 [2]重庆市中医院放射科,重庆400021 [3]重庆市中医院放呼吸科,重庆400021

出　　处：《中国CT和MRI杂志》2023年第1期62-65,共4页Chinese Journal of CT and MRI

基　　金：重庆市中医院第二批青年拔尖人才专项(CQSZYY2021002);重庆市中医院首批青年拔尖人才专项(CQSZYY2020017);成都中医药大学校级基地教改建设项目(XJG2019-11950);北京中医药大学教育科学研究课题项目(XJYB2087)。

摘　　要：目的 探讨多种CT征象在鲍曼不动杆菌肺炎诊断中的价值。方法 回顾性分析经痰液培养证实162例鲍曼不动杆菌肺炎(ABP)与肺炎克雷伯杆菌肺炎(KP)患者190例的临床资料及薄层CT影像学表现等情况,由2名放射科医师进行分析并进行记录,对多种CT征象进行统计分析。结果 多因素Logistic回归分析显示弥漫纯磨玻璃影或磨玻璃结节、肺实变、胸腔积液更常见于鲍曼不动杆菌肺炎中(P<0.05),OR值分别为9.120(95%CI:5.212-18.121)、11.332(95%CI:5.2310-18.662)和13.452(95%CI:6.882-22.991),近端或远端支气管壁增厚、实性结节、网格状改变、支气管扩张、马赛克灌注、空洞及淋巴结肿大在多因素分析中无统计学意义(P>0.05)。三种阳性单一征象中,弥漫纯磨玻璃影或磨玻璃结节敏感度最高(64.21%),肺实变特异度最高(68.23%),两种联合征象中,弥漫纯磨玻璃影或磨玻璃结节+肺实变敏感度(72.95%)最高,肺实变+胸腔积液特异度(70.44%)最高,三种征象联合时,敏感度及特异度分别为75.88%、74.64%。结论 弥漫纯磨玻璃影或磨玻璃结节、肺实变、胸腔积液在鲍曼不动杆菌肺炎的诊断中具有重要价值,多种征象联合观察能有效提高鲍曼不动杆菌肺炎诊断的特异度,从而提高ABP诊断的准确性。Objective to investigate the diagnostic value of multiple CT signs in Acinetobacter Bauman pneumonia. Methods The clinical data of 162 patients with Acinetobacter baumannii pneumonia(ABP) and Klebsiella pneumoniae pneumonia(KP) confirmed by sputum culture and the thin slice CT imaging findings of 190 patients were analyzed and recorded by two radiologists, and various CT signs were statistically analyzed. Results Multivariate logistic regression analysis showed that diffuse groundglass opacity or ground-glass nodules, consolidation of lung and pleural effusion were more common in Acinetobacter baumannii pneumonia(P<0.05), and the OR values were 9.120(95% CI: 5.212-18.121), 11.332(95% CI: 5.2310-18.662) and 13.452(95% CI: 6.882-22.991), respectively. There were no significant differences in wall thickening, solid nodules, reticular changes, bronchiectasis, mosaic perfusion, cavity and lymphadenopathy among the multivariate analysis(P>0.05). Among the three positive single signs, diffuse ground-glass opacity or ground-glass nodule had the highest sensitivity(64.21%) and lung consolidation specificity(68.23%). Of the two combined signs, diffuse groundglass opacity or ground-glass nodule + lung consolidation sensitivity(72.95%) was the highest, lung consolidation + pleural effusion specificity(70.44%) was the highest. When combined with signs, the sensitivity and specificity were 75.88% and 76.64% respectively. Conclusion Diffuse ground-glass opacity or ground-glass nodules, lung consolidation, pleural effusion in the diagnosis of Acinetobacter baumannii pneumonia has important value, a variety of signs combined observation can effectively improve the specificity of the diagnosis of Acinetobacter baumannii pneumonia, thereby increasing the accuracy of ABP diagnosis.

关 键 词：鲍曼不动杆菌肺炎 CT 多因素分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]