肺部感染患者胸部MSCT征象与感染程度的关系  

Relationship between chest MSCT signs of patients with pulmonary infection and severity of infection

作　　者：吴婷 赵永强 周涛 尹波 贾守强 WU Ting;ZHAO Yong-qiang;ZHOU Tao;YIN Bo;JIA Shou-qiang(Shandong First Medical University Affiliated People's Hospital,Jinan,Shandong 271199,China)

机构地区：[1]山东第一医科大学附属人民医院影像科,山东济南271199 [2]山东第一医科大学附属人民医院胸心外科,山东济南271199

出　　处：《中华医院感染学杂志》2024年第17期2621-2625,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技计划项目(202105010536)。

摘　　要：目的分析肺部感染患者胸部多层螺旋计算机断层扫描(MSCT)征象与感染程度的关系。方法选择2020年1月-2023年8月山东第一医科大学附属人民医院收治的312例肺部感染患者纳入研究,其中病毒感染25例,真菌感染51例,非特异性细菌感染124例,混合感染112例。分析患者MSCT征象分布情况,比较不同MSCT图像征象患者临床肺部感染评分(CPIS)、急性生理和慢性健康状况评估(APACHEⅡ)评分,分析不同病原所致肺部感染MSCT征象特征。结果312例肺部感染患者,累及多个肺叶比例更高(53.85%),异常表现为肺实变改变比例更高(48.40%);多个肺叶肺部感染患者CPIS、APACHEⅡ评分高于单一肺叶肺部感染患者(P<0.05);斑片影肺部感染患者CPIS、APACHEⅡ评分高于肺实变、磨玻璃样改变肺部感染患者(P<0.05),肺实变肺部感染患者CPIS、APACHEⅡ评分高于磨玻璃样改变肺部感染患者(P<0.05)。病毒感染累及单一肺叶为主(占比56.00%),真菌感染、非特异性细菌感染、混合感染累及多个肺叶为主(占比56.86%、53.23%、55.36%),异常表现病毒感染、真菌感染、混合感染以磨玻璃样改变为主(占比52.00%、41.18%、38.39%),非特异性细菌感染以肺实变为主(占比79.03%)。结论MSCT有助于显示肺部感染患者感染范围及异常改变,MSCT征象与感染程度有关,还可辅助判断感染类型。OBJECTIVE To analyze the relationship between chest multilayer spiral computed tomography(MSCT)signs of the patients with pulmonary infection and severity of the infection.METHODS A total of 312 patients with pulmonary infection who were treated in the Affiliated People′s Hospital of Shandong First Medical University from Jan 2020 to Aug 2023 were enrolled in the study,25 of whom were viral infection,51 were fungal infection,124 were non-specific bacterial infection,and 112 were mixed infections.The distribution of MSCT signs was observed,the clinical pulmonary infection score(CPIS)and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score were compared among the patients with different MSCT image signs,and the features of MSCT signs were observed and compared among the patients with the pulmonary infections caused by different pathogens.RESULTS Among the 312 patients with pulmonary infection,53.85%had multiple pulmonary lobes involved,and 48.40%presented lung consolidation as abnormal manifestation.The CPIS and APACHEⅡscore of the patients with multiple lobes of pulmonary infection were higher than those of the patients with single lobe of pulmonary infection(P<0.05).The CPIS and APACHEⅡscore of the patients with patch shadow pulmonary infection were higher than those of the patients with lung consolidation,ground-glass change pulmonary infection(P<0.05);the CPIS and APACHEⅡscore of the patients with lung consolidation pulmonary infection were higher than those of the patients with ground-glass change pulmonary infection(P<0.05).The patients with single lung lobe involved accounted for 56.00%among the patients with viral infection;while the patients with multiple lobes involved accounted for 56.86%among the patients with fungal infection,53.23%among the patients with non-specific bacterial infection,55.36%among the patients with mixed infections.Among the patients with abnormal manifestations,the patients with ground-glass change accounted for 52.00%among the patients with viral infection,41.0

关 键 词：肺部感染 胸部 多层螺旋计算机断层扫描 征象 感染程度 

分 类 号：R563.1[医药卫生—呼吸系统]