高分辨率CT半定量分值判断特发性间质性肺炎患者应用糖皮质激素的近期疗效

Short term efficacy of glucocorticoids in patients with idiopathic interstitial pneumonia evaluated by high resolution CT semi quantitative scores

目的研究分析高分辨率CT半定量分值判断特发性间质性肺炎患者应用糖皮质激素的近期疗效。方法选取兰溪市人民医院2015年5月~2016年10月收治的50例特发性间质性肺炎患者为研究对象,分析临床资料,包括吸烟情况、入院体征、呼吸困难评分等。高分辨率CT层面为右膈肌顶、气管分叉处水平、左心房顶,在选取的3个层面上计算蜂窝病以及网格影所占百分比的算数平均值,高分辨率CT分值的临界点分别为10%、20%、30%以及40%。分析研究糖皮质激素的准确度、敏感度以及特异度等指标,利用卡方检验对计数资料进行相关检验。结果高分辨率CT分值为20%临界点时,准确度为72.0%。进行糖皮质激素治疗的患者中,高分辨率CT分值大于等于20%患者为25例,分值小于20%的患者为25例。大于等于20%的患者住院期间病死例数为10例,病死率为40.0%,近期糖皮质激素治疗有效率为8.0%。小于20%的患者住院期间病死例数为1例,病死率为4.0%,近期糖皮质激素治疗有效率为50.0%。14例患者明确病理类型,高分辨率CT半定量分值大于20%为6例,均为普通型间质性肺炎,小于等于20%患者中,7例为非特异性间质性肺炎,1例患者为急性间质性肺炎。结论高分辨率CT半定量分值判断特发性间质性肺炎患者应用糖皮质激素的近期疗效准确度较高,20%高分辨率分值准确度较高,与病例诊断结果吻合度较高,具有临床进一步推广和应用的意义。

Objective To study and analyze the short-term effect of glucocorticoid in patients with idiopathic interstitial pneumonia by analyzing the semi quantitative scores of high resolution CT. Methods 50 cases of idiopathic interstitial pneumonia treated in our hospital from May 2015 to October2016 were selected as the research object. Clinical data were analyzed,including smoking,signs of hospitalization and dyspnea score. High resolution CT level for the right diaphragmatic top tube,bifurcation,left atrium roof,in 3 aspects from the calculation of cellular disease and shadow grid as a percentage of average,the critical point of high resolution CT scores were 10%,20%,30%,40% and 50%. The accuracy,sensitivity and specificity of glucocorticoids were analyzed. The chi square test was used to examine the enumeration data. Results The accuracy was 72% when the high resolution CT score was 20% critical point. In patients treated with corticosteroids,the high resolution CT score was greater than or equal to 20% for patients and25 for patients with a score of less than 20% for 25 patients. 20% or more patients died during hospitalization,10 cases,the mortality rate was 40%,and the effective rate of glucocorticoid treatment was 8%. Less than 20% of the patients died during hospitalization,1 cases,the mortality rate was 4%,and the effective rate of glucocorticoid treatment was 50%. Conclusion High resolution CT semi quantitative score judgment of idiopathic interstitial pneumonia patients treated with glucocorticoid efficacy of high accuracy,high resolution 20% scores higher accuracy,and the diagnosis is well,with further clinical promotion and application significance.