免疫损害与免疫正常患者浸润性肺结核CT表现的对比研究

Comparative study between CT findings of pulmonary tuberculosis in immunocompromised and immuned normal patients

目的分析比较免疫损害与免疫正常患者浸润性肺结核的CT表现。方法回顾性分析2006年～2009年我院213例确诊为浸润性肺结核患者的胸部CT表现,根据是否有免疫损害将其分为免疫损害组和免疫正常组,分析比较两组肺结核的CT表现。结果免疫损害组18例,免疫正常组195例。免疫损害组与免疫正常组累及肺段以上片状实变影分别为77.78%、24.62%,单一病变内多发小空洞分别为66.67%、9.23%,淋巴结肿大分别55.56%29.78%,差异有统计学意义(P<0.05)。免疫损害组与免疫正常组结节(38.39%、42.05%)、叶芽征(50.0%、45.64%)及胸腔积液(61.11%、50.26%)的发生率差异无统计学意义(P>0.05)。结论与免疫正常患者的浸润性肺结核比较,肺段以上片状实变影、单一病变内多发小空洞及淋巴结肿大更常见于免疫损害患者。

Objective To evaluate the CT features of pulmonary tuberculosis between immunocompromised patients compared with immuned normal patients. Methods The complete data, including chest CT scanning and laboratory results of 213 patients with pulmonary tuberculosis from 2006 to 2009 were retrospectively studied. The patients were classified as immunocompromised group （18 cases） and immuned normal group （195 cases） and the CT features of these two groups were compared. Results CT features of tuberculosis in immunocompromised group included larger confluent consolidation（77.78%）, multiple small cavities within any given lesion （66.67%）, nodular opacities （38.39%）, tree-in-bud （50.0%）, pleural effusion （61.11%） and enlarged mediastinal lymph nodes （55.56%）. CT findings of tuberculosis in immuned normal group included larger confluent consolidation （24.62%）, multiple small cavities within any given lesion （9.23%）, nodular opacities （42.05%）, tree-in-bud （45.64%）, pleural effusion （50.26%） and enlarged mediastinal lymph nodes （29.78%）. There were significantly differences （P〈 0.05） in the findings of larger confluent consolidation,multiple small cavities within any given lesion,and enlarged mediastinal lymph nodes, without any significantly differences （P 〉 0.05）in the findings of nodular opacities,tree-in-bud, pleural effusion. Conclusion Immunocompromised patients have a higher prevalence of larger confluent consolidation, multiple small cavities within a given lesion and enlarged mediastinal lymph nodes than immuned normal patients.