高龄患者支原体肺炎CT诊断的临床分析

Clinical analysis of CT diagnosis of advanced patiens with Mycoplasma pneumonia

目的探讨高龄患者支原体肺炎的CT表现特点，为临床诊断提供重要依据。方法收集医院2009年2月～2012年3月收治的80例支原体肺炎高龄患者，其中女44例，男36例；年龄62-92岁，平均（72．5±2．8）岁；所选患者均经血清学证实为支原体肺炎高龄患者，对所选的80例患者CT表现进行回顾性分析，采用SPSS17．0软件对所有数据进行统计分析，率的比较采用7。检验。结果80例高龄支原体肺炎患者CT表现的主要特点为病程变化多样，且病变分布很广泛，双侧多叶肺组织均受累，而尤以左肺下叶多见54例，占67．5％；以斑片状影72例、混合型47例、磨玻璃影32例、大片实变影16例、腺泡结节影12例、间质浸润性病变11例、胸腔积液7例及纵隔淋巴结肿大4例，分别占90．0％、58．8％、40．0％、20．0％、15．0％、13．8％、8．8％及5．0％；磨玻璃影、斑片影及混合型，明显多于大片实变影及间质浸润性病变等，差异有统计学意义（P〈0．05）。结论高龄患者多见支原体肺炎的CT表现变化多样且分布很广，双侧多叶肺组织均受累以左肺下叶为最，以磨玻璃影、斑片状影、混合型多见，为临床诊断高龄患者的支原体肺炎提供重要依据。

OBJECTIVE To explore the characteristics of CT manifestations of the advanced patients with Mycoplasma pneumonia so as to provide basis for the clinical diagnosis. METHODS A total of 80 cases of advanced patients with M. pneumonia, who were treated in the hospital from Feb 2009 to Mar 2012, were enrolled in the study, including 44 cases of females and 36 cases of males, with the age varying between 62 and 92 years old, median age （72.5±2.8） years; all the picked subjects were proved as the M. pneumonia through serological test, then the CT manifestations of the 80 subjects were retrospectively analyzed, the test data were statistically analyzed with the use of SPSS17.0 software, and the ratio was compared by using the chi-square test. RESULTS The CT manifestations of the 80 advanced patients were diversified and distributed widely, with bilateral multiple lung lobe tissues involved, there were 54 （67.5%） cases of left lower lobe, 72 cases of patchy shadows, 47 cases of mixed type, 32 cases of ground-glass opacity, 16 cases of consolidation shadows, 12 cases of acinar nodular shadows, 11 cases of pulmonary interstitial infiltration, 7 cases of pleural effusion, and 4 cases of mediastinal lymph node enlargement, accounting for 90.0%, 58.8%, 40.0%, 20.0%, 15.0%, 13.8%, 8.8%, and 5.0%, respectively. The cases of the ground-glass opacity, patchy shadows, or mixed type were significantly more than the cases of the consolidation shadows or pulmonary interstitial infiltration, the difference was statistically significant （P〈0.05）. CONCLUSION The CT manifestations of the advanced patients with M. pneumonia are diversified and distributed widely; the left lower lobe lesion involved is dominant among the bilateral multi-bilateral lung lobe involved, and the ground-glass opacity, patchy shadow, and mixed type are common, which provides important bases for the clinical diagnosis of M. pneumonia in the advanced patients.