119例肺结核患者痰涂阳与胸部X线表现的对比研究

A comparative study of the correlation between sputum smears positive and the chest X-ray features of 119 cases with pulmonary tubercolosis

目的探讨肺结核患者痰涂阳与胸部X线表现之间的关联性,为有关科室及时采取措施防治结核病提供参考。方法对119例肺结核患者痰涂阳与胸部X线表现进行回顾性分析,按痰涂阳1＋~2＋和3＋~4＋将其分为痰涂阳程度低和程度高的两组作对比研究,对结果采用SPSS 13.0统计软件进行处理;采用χ2检验及多因素非条件logistic回归分析进行统计学处理,以P〈0.05为有统计学意义。结果肺结核患者是否具有传染性（即痰涂阳）与肺结核病灶分布部位（涂阳1＋~2＋组与3＋~4＋组在左右肺病灶分布分别为90个和88个,经比较：χ2=0.208,P=0.649）、范围（本组涂阳1＋~2＋组其病灶范围为2.37个肺野/例：180个/76例;3＋~4＋组为2.33个肺野/例：100个/43例,χ2=0.006,P=0.936）、空洞大小（χ2=3.300,P=0.069,OR=2.028,95%CI：1.012~4.350）、有无引流支气管（χ2=0.092,P=0.761,OR=0.889,95%CI：0.418~1.894）的差异无统计学意义;与其分型（本组Ⅲ型110例,占92.4%）、分期（本组进展期79例,占66.4%;好转期33例,占27.7%;稳定期7例,占5.9%）、X线表现中空洞分布范围（χ2=13.553,P=0.000,OR=2.283,95%CI：1.471~3.543）、数目（χ2=15.427,P=0.000,OR=2.474,95%CI：1.574~3.887）、洞壁情况（χ2=11.166,P=0.001,OR=2.691,95%CI：1.506~4.808）等差异有统计学意义。结论肺结核患者痰涂阳及菌量与胸部X线表现之间有明显的关联性。

Objective To explore the correlation between sputum smear-positive and chest X-ray features of patients with pulmonary tuberculosis（PTB） in order to provide the reference for management of PTB. Methods Chest X-ray features of 119 cases of smear-positive pulmonary tuberculosis who were divided into two groups according to sputum-smear 1＋ to 2＋ or 3＋ to 4＋ were reviewed and analyzed by Chi square and multivariate non-conditional logistic regression analysis with P0.05 being considered statistically significant. Results There were no correlation between sputum mycobacteria condition and lesion distribution and range in patients with PTB.In sputum-smear 1＋ to 2＋ group and 3＋ to 4＋ group,there were 90 and 88 lesions（χ2=0.208,P=0.649）,2.37 and 2.33 lung fields in each case（χ2=0.006,P=0.936）.There were also no correlation between sputum mycobacteria condition and cavity size（χ2=3.300,P=0.069） with or without draining bronchi（χ2=0.092,P=0.761）.Sputum condition were related to X-ray features of the type（type Ⅲ 110 cases,92.4%）,stage（advanced stage 79 cases,66.4%;resolving stage 33 cases,27.7%;stable stage 7 cases,5.9%）,the cavities＇ distribution（χ2=13.553,P=0.000）,the cavity number（χ2=15.427,P=0.000）,and the cavity wall condition（χ2=11.166,P=0.001）. Conclusion There was a closed correlation between sputum smear-positive condition and chest X-ray features in patients with PTB.