矽肺并肺结核16例的临床特点及CT影像表现分析

Analysis of the Clinical Features and CT Imaging of Silicosis with Pulmonary Tuberculosis in 16 Cases

目的分析矽肺并肺结核患者临床特点及CT影像表现。方法选取2014年6月至016年12月我院收治的矽肺并肺结核患者16例,分析其发病特点、影像表现,比较胸部X线与CT诊断准确率及病理特征检出情况。结果矽肺并肺结核发病主要表现为胸闷(75.00%)、咳嗽(56.25%)、气促(43.75%)、胸痛(50.00%),部分患者伴盗汗、低热、抑郁症状;X线显示胸片小阴影改变,见团块阴影,阴影密度不均匀,边缘清晰,周围无肺气肿,CT显示点状钙化灶、陈旧性结合灶及双肺弥漫性间质纤维化,病灶主要分布于血管支气管束周围;CT诊断矽肺并肺结核的准确率明显高于X线(P<0.05);CT对小结节影、结核钙化及肺气肿的检出率明显高于X线(P<0.05)。结论矽肺并肺结核以胸闷、咳嗽、气促、胸痛伴盗汗、低热、抑郁为主要症状,CT检查可见特征性影像学改变,值得在临床推广应用。

Objective To analyze the clinical features and CT imaging of silicosis with pulmonary tuberculosis in 16 cases.Methods Sixteen patients with silicosis and pulmonary tuberculosis who were admitted to the hospital between June 2014 and December 2016 were enrolled in the study.Their clinical features and imaging findings were analyzed.The diagnostic accuracy and pathological characteristics were compared between chest X-ray and CT.Results The main manifestations of silicosis and pulmonary tuberculosis include chest distress(75.00%),cough(56.25%),shortness of breath(43.75%)and chest pain(50.00%).Some patients had night sweat,low-grade fever and depression.Chest X-ray showed small shadow changes,massive shadow,inhomogeneous density,clear edges and no emphysema.CT showed punctate calcification,old combined lesions and diffuse lung fibrosis in bilateral lungs.The lesions were mainly located around the vascular bundle.The accuracy of CT in the diagnosis of silicosis and pulmonary tuberculosis was significantly higher than that of X-ray(P<0.05).The detection rates of CT for small nodules,calcified tuberculosis and emphysema were significantly higher than those of X-ray(P<0.05).Conclusion The main symptoms of silicosis and pulmonary tuberculosis include chest tightness,cough,shortness of breath,chest pain,night sweats,low-grade fever and depression.CT shows typical imaging findings and it is worthy of clinical application.