口服百草枯致中毒性肺损伤的胸部CT表现

Chest CT Features of Oral Paraquat-induced Lung Injury

目的探讨口服百草枯（PQ）致中毒性肺损伤的胸部CT表现,以提高对PQ中毒的认识。资料与方法回顾性分析74例口服PQ中毒患者的胸部CT表现,按中毒剂量分为少量组28例（≤10 ml）、中量组34例（11-50 ml）、大量组12例（〉50 ml）,按病程分为早期（1-7 d）、中期（8-14 d）、晚期（〉14 d）,对比不同CT表现与剂量、时间的关系,分析病变的分布范围。结果 PQ中毒患者胸部CT表现随时间增加呈现出从肺纹理增多、磨玻璃征,到渗出与实变,再向肺纤维化转变的特点,并与中毒剂量相关（P〈0.05）;肺内渗出与实变主要分布于双肺野外带,表明病变范围具有特征性。结论口服PQ致中毒性肺损伤的胸部CT表现有一定的特征性,其损伤程度与剂量、时间有关,对临床诊断及治疗有指导意义。

Purpose To investigate the chest CT features of lung injury caused by oral paraquat, and deepen the understanding of paraquat poisoning. Materials and Methods The chest CT features of 74 patients with lung injury caused by oral paraquat were analyzed retrospectively and comparatively. 74 patients were divided into 3 groups according to toxic dose： 28 cases in the low dose group（paraquat dose less than 10 ml）, 34 cases in the medium dose group（paraquat dose among 11 to 50 ml）, and 12 cases in the large dose group（paraquat dose more than 50 ml）. 74 patients were also divided into 3 groups according to course of disease： The course of disease among 1 to 7 days were in the early period, 8 to 14 days in the medium period, and 14 days later in the later period. The image features were summarized by comparing the chest CT features, with toxic dose, course of disease, and the scope of lung injury. Results Poisoned patient＇s chest CT features, related with toxic dose（P〈0.05）, appeared from increased bronchovascular shadows, ground glass opacity, to effusion and consolidation, and to pulmonary fibrosis along with time. The effusion and consolidation majorly located in the lateral lungs, which showed a characteristic disease extent. Conclusion The chest CT features of lung injury, caused by oral paraquat, have a certain characteristic. It relates to toxic dose and course of disease, which has a certain guiding significance to clinical diagnosis and treatment.