影像学对肺念珠菌病诊断价值分析

Clinical diagnostic value of dynamic imaging change in pulmonary candidiasis

目的观察肺念珠菌病患者肺部病灶影像学的动态变化，并分析影像学对肺假丝酵母菌属感染的临床诊断价值。方法收集35例肺念珠菌病患者在明确诊断前使用抗细菌治疗及在明确诊断后抗真菌治疗前后的胸部X线和（或）CT肺部病灶影像学图像，对2种治疗方法前后肺部病灶的动态变化进行回顾性比较分析。结果35例患者抗细菌治疗后，肺部病灶无吸收10例（28．57％），加重18例（51．43％），出现新病灶7例（20．00％），合计治疗有效率为0．00％；改用抗真菌治疗后，29例患者肺部病灶有不同程度的吸收，病灶无变化3例（8．57％），加重2例（5．71％），出现新病灶1例（2．86％），治疗有效率82．86％；两组治疗有效率比较，差异具有统计学意义（χ^2=50．07，P〈0．01）。结论动态追踪观察原因不明肺部感染患者治疗前后的肺部影像学变化，有助于肺念珠菌病的早期诊断和治疗。

Objective To observe the dynamic imaging change in pulmonary candidiasis and to evaluate the clinical diagnostic value of imaging for pulmonary candidiasis. Methods The chest X-ray and/or CT imaging of 35 patients with pulmonary candidiasis were collected, the dynamic imaging change between antimicrobial therapy before diag- nosis and antifungal therapy after diagnosis was compared and analysed retrospectively. Results For 35 patients reeiving antimierobial therapy before diagnosis, there were 10 cases （28. 57%） with no imaging change, 18 （51.43%） with progressive imaging change and 7 （20. 00%） with new imaging focuses, the total therapeutic effeeive rate was 0. 00%, but for antifungal therapy after diagnosis, there were 29 cases with improved imaging change, （8. 57%） with no imaging change, 2 （5. 71%） with progressive imaging change, and 1 （2. 86%） with new imaging focus, the total therapeutic effective rate was 82. 86% ; The difference between two treatments was statistically ignificant（χ^2 = 50. 07, P〈0. 01 ）. Conclusion The observation of the dynamic imaging change in pulmonary infec- ion of unknown origin before and after treatment is valuable for early diagnosis and treatment of pulmonary candidisis.