肺念珠菌病急性期CT表现演变规律的动物实验研究

An animal experiment of pulmonary candidiasis:the developing tendency of CT findings at the early stage

目的通过建立动物模型探讨不同免疫状态及感染途径下肺白念珠菌病急性期CT表现的演变规律及其与病理学改变的关系。方法将40只新西兰大白兔分为四组分别建立免疫正常及免疫抑制状态下原发及继发性肺念珠菌病模型,接种后隔日一次行CT扫描并动态观察各组兔肺部CT表现,并与尸检病理结果对照。结果成功建立兔肺念珠菌病模型23例,CT表现混合型病变(16/23),弥漫性(14/23)分布为主,包括磨玻璃影19例,呈弥漫性分布7例,多发片状分布9例,局灶性分布3例;实变影11例,其中弥漫性分布5例,多发片状分布5例,单发1例;结节影10例,8例结节首次出现以分布于外周带为主,其中6例逐渐向中央带进展呈弥漫性分布,2例无明显进展趋势;2例分布于支气管血管束周围。病理表现为渗出性或增殖性肺泡损伤和/或间质炎症19例,出血性坏死9例,血管栓塞8例,肉芽肿性炎症3例。结论肺念珠菌病急性期CT表现的演变规律具有一定的特点。

Objective To investigate the developing tendency of CT findings and pathological findings in pulmonary can-didiasis at acute stage ,by establishing animals model of different immune status and different infective routes .Methods Forty New Zealand rabbits were divided into four groups randomly （A ,B ,C ,D） for establishing animals model of prima-ry and secondary pulmonary candidiasis in immunocompetent and immunosuppressed status .Chest CT scan was performed before and on alternative days after inoculation/injection .Microbiological and pathological results were obtained by autop-sy .Results Pulmonary candidiasis was successfully established in 23 rabbits confirmed by microbiology and pathology . Lesions in each group were mixed pattern （16/23） and mainly in diffuse distribution （14/23） .The main CT findings were GGO （19/23） ,which showed diffuse distribution in 7 cases ,multiple patchy in 9 cases ,focal distribution in 3 cases ,fol-lowed by consolidation （11/23） ,which showed diffuse distribution in 5 cases ,multiple patchy in 5 cases ,focal distribution in 1 case .Nodules present in 10 cases ,in which 8 cases mainly distributed in the peripheral zone with spread into the cen-tral zone in 2 cases and no tendency to progress in 2 cases of nodules were distributed around the bronchovascular bundles . Pathological findings corresponded to the exudative or proliferative phase of diffuse alveolar inflammation or interstitial hy-perplasia in 19 cases ,well-defined hemorrhagic infarcts in 9 cases ,thrombus in 8 cases ,and granulomatous inflammation in 3 cases .Conclusion Developing tendency of CT findings in pulmonary candidiasis at acute stage had certain characteris-tics .