百草枯中毒肺部损伤CT演变及预后分析

Lung CT variation and prognosis of lung injury caused by parquet intoxication

目的分析百草枯中毒肺损伤的CT表现和临床特点,从而提高对百草枯中毒肺损伤的认识。方法回顾性分析安徽省立医院2010年12月至2017年11月75例百草枯中毒肺损伤病例的CT影像和临床资料,根据百草枯的中毒时间分为早期(1-7天)、中期(8-21天)、后期(≥22天)和中毒剂量分为少量组(≤10 m L)25例、中量组(11-30 m L)20例、大量组(>30 m L)30例,对比分析各组CT表现。结果 75例百草枯中毒中,磨玻璃影,肺实变,肺纤维化与不同时间之间存在统计学差异(χ~2=15.354,P=0.00,χ~2=10.446,P=0.004,χ~2=7.572,P=0.028),且早期CT主要表现为磨玻璃影(78.33%),中期主要为肺实变(74.47%),后期主要为肺纤维化(72.50%)。磨玻璃影,肺实变,肺纤维化与不同剂量之间存在统计学差异(P<0.05),且中毒少量组以磨玻璃影主要表现(76.00%)、中量组以磨玻璃影(70.00%)及实变(75.00%)为主要表现、大量组以实变(70.00%)、肺纤维化(90.00%)为主要表现。结论百草枯中毒肺损伤的CT表现具有一定的特征性,其表现与剂量、时间有关,对临床诊断和治疗有一定指导价值。

Objective To investigate the CT features of pulmonary injury caused by paraquat poisoning and to improve the understanding of paraquat poisoning for clinic.Methods The clinical and imaging data of lung injury in 75 cases of paraquat poisoning from December 2010 to November 2017 were analyzed retrospectively.According to different periods of paraquat poisoning,the 75 cases were divided into 3 types： the early stage of poisoning（ within 1-7 days）,the middle stage of poisoning（8-14 days）,and the late stage of poisoning（ ≥22 days）.There were25 cases in the mild dose group（ ≤10 m L）,20 cases in the moderate dose group（11-30 m L）,and 30 cases in the large dose group（ 〉30 m L） according to the dose of paraquat intoxication.Comparison of the CT findings was performed with the chi-square test.Results In 75 cases of paraquat poisoning,there were statistical differences among ground glass opacity,pulmonary consolidation,pulmonary fibrosis and different periods（ χ~2= 15.354,P = 0.00; χ~2= 10.446,P = 0.004; χ~2= 7.572,P = 0.028）.The main pattern in the early stage was ground glass opacity（78.33%）,the main pattern in the middle stage was pulmonary consolidation（74.47%）,and the main pattern in the late stage was pulmonary fibrosis（72.50%）.There were statistical differences among ground glass opacity,pulmonary consolidation,pulmonary fibrosis and different doses（ P〈0.05）.The main imaging change was ground glass opacity（ 76.00%） in the mild dose group,ground glass opacity（ 70.00%） and pulmonary consolidation（75.00%） in the moderate dose group,and pulmonary consolidation（70.00%） and pulmonary fibrosis（90.00%）in the large dose group.Conclusion There are some features in CT manifestations of pulmonary injury caused by paraquat poisoning,and it relates to toxic dose and course of disease,which is helpful for the evaluation of the clinical diagnosis and treatment.