肺间质改变为主的继发性肺结核临床特征及CT影像学分析  

Clinical features and CT imaging analysis of secondary pulmonary tuberculosis mainly with pulmonary interstitial changes

作　　者：邓勇 田毅 杨小芸 DENG Yong;TIAN Yi;YANG Xiaoyun(Department of Imaging,The First People’s Hospital of Yuexi County,Panzhihua 617023,Sichuan,China;Department of Oncology,Affiliated Hospital of Panzhihua University,Panzhihua 617000,Sichuan,China)

机构地区：[1]越西县第一人民医院影像科,四川攀枝花617023 [2]攀枝花学院附属医院肿瘤科,四川攀枝花617000

出　　处：《西藏医药》2023年第3期15-17,共3页Tibetan Medicine

摘　　要：目的分析肺间质改变为主的继发性肺结核临床特征及CT影像学特征。方法回顾性分析2019年4月~2021年4月越西县第一人民医院收治的96例肺间质改变为主的继发性肺结核患者的临床资料,观察患者临床特征和CT影像学特征。结果96例肺间质改变为主的继发性肺结核患者中,包括无症状者13例(13.54%),轻度咳嗽48例(50.00%),出现明显呼吸道症状和结合中毒症状35例(36.46%);上肺叶发病74例(77.08%),其他肺叶发病22例(22.92%);呈片状融合分布29例(30.21%),支气管树分布者67例(69.79%);其中痰涂片阳性者中还出现52例(54.17%)空洞病变,阴性者无空洞病变。其高分辨率CT(HRCT)影像图中,小叶内细网织线影96例(100.00%),微结节影96例(100.00%),树芽征88例(91.66%),磨玻璃样密度影46例(47.91%),小叶间隔增厚33例(34.38%),细支气管壁增厚36例(37.50%)。结论肺间质改变为主的继发性肺结核患者以轻度咳嗽、出现明显呼吸道症状最为常见,多于上肺叶发病,多呈支气管树分布,痰涂片阳性者多存在空洞病变,其HRCT影像学中以小叶内细网织线影、微结节影及树芽征最为多见。Objective To analyze the clinical features and CT imaging features of secondary pulmonary tuberculosis mainly with pulmonary interstitial changes.Methods The clinical data of 96 patients with secondary pulmonary tuberculosis mainly with pulmonary interstitial changes who were treated in the First People’s Hospital of Yuexi County were retrospectively analyzed between April 2019 and April 2021,and the clinical features and CT imaging features of the patients were observed.Results Among 96 patients with secondary pulmonary tuberculosis mainly with pulmonary interstitial changes,there were 13 asymptomatic cases(13.54%),48 cases(50.00%)of mild cough and 35 cases(36.46%)of obvious respiratory symptoms and poisoning symptoms,and there were 74 cases(77.08%)of upper lobe diseases and 22 cases(22.92%)of other lobe diseases,and there were 29 cases(30.21%)with lamellar fusion distribution and 67 cases(69.79%)with bronchial tree distribution.There were 52 cases(54.17%)of cavity lesions among patients with positive sputum smears and there were no cavity lesions among negative patients.High-resolution CT(HRCT)images showed fine reticulate shadow in leaflet in 96 cases(100.00%),micronodular shadow in 96 cases(100.00%),tree-in-bud sign in 88 cases(91.66%),ground glass opacity in 46 cases(47.91%),interlobular septal thickening in 33 cases(34.38%)and bronchial wall thickening in 36 cases(37.50%).Conclusion Mild cough and obvious respiratory symptoms are the most common symptoms in patients with secondary pulmonary tuberculosis mainly with pulmonary interstitial changes which mainly occur in the upper lobe and are mostly distributed in the form of bronchial tree.The patients with positive sputum smears are more likely to have cavity lesions,and HRCT imaging shows fine reticulate shadow in leaflet,micronodular shadow and tree-in-bud sign.

关 键 词：肺间质改变 继发性肺结核 临床特征 CT影像学 

分 类 号：R521[医药卫生—内科学]