耐多药与药物敏感肺结核的CT影像学表现

CT imaging comparison of multi-drug resistant tuberculosis and drug sensitive tuberculosis

目的 对比耐多药肺结核与药物敏感肺结核的CT影像学表现,提高对耐多药肺结核的认识.方法 选取2013年3月至2014年3月80例耐多药肺结核患者作为观察组,另选取同期80例药物敏感肺结核患者作为对照组.所有患者均于治疗前后进行胸部CT扫描,比较两组患者CT影像学表现上的病变范围和病变形态,并对比治疗前后患者病变部位的变化情况.结果 观察组患者肺内病灶形态多样,分布广泛,且全肺叶受侵者明显多于对照组,差异有统计学意义（χ^2=6.476,P=0.011）;与对照组比较,观察组患者的病变形态中出现肺内实变、广泛播散灶、多发空洞、胸膜增厚,合并毁损、支气管扩张及气胸者明显增多,差异有统计学意义（P均〈0.05）;与对照组比较,观察组患者经治疗后病灶明显吸收者较少,而病变进展者相对较多,差异有统计学意义（P均〈0.05）.结论 耐多药肺结核病灶形态多样,分布广泛,易发生广泛播散、多发空洞及其他严重并发症,治疗效果及预后均相对较差.

Objective To compare the CT imaging of multi-drug resistant tuberculosis（MDR-TB） and drug sensitive tuberculosis, and improve the understanding of multi-drug resistant tuberculosis.Methods Eighty patients with MDR-TB from March 2013 to March 2014 were selected as the observation group, and another 80 patients with DS-TB at the corresponding period were selected as the control group.All the patients were performed chest CT scans before and after treatment.The scope and shapes of lesions in the CT imaging and the change of position of the injury before and after treatment were compared.Results The lung lesions of observation group were diverse and widespread, and the patients with whole pulmonary metastasis were more than the control group, the differences were significant （χ^2=6.476, P=0.011）;compared with the control group, the consolidation, widely spread nidus, multiple cavity, pleural thickening, combined with damaged, bronchial dilation and pneumothorax of the lungs were evidently increased, the differences were significant （P〈0.05）;the lesions absorbed in the observation group were less than those in the control group, and lesions evolved were more than those in the control group, the differences were significant （P〈0.05）.Conclusions The lung lesions of the patients with multi-drug resistant tuberculosis are diverse and widespread, and prone to widely spread, multiple cavity and other serious complications, the therapeutic effect and prognosis are relatively poor.