运用能谱CT对肺曲霉菌病诊断及临床治疗疗效评估研究

Evaluation of the Diagnosis and Clinical Treatment of Pulmonary Aspergillosis by Energy Spectrum CT

目的探究肺曲霉菌病诊断与治疗中运用能谱CT的作用。方法从我院2016年至2017年间经病理活检确诊为感染肺曲霉菌病的130例患者中,选择65例做为对照组,在复检中仅用血液霉菌培养;另选择65例患者作为研究组,在复检中以对照组为基础联用能谱CT。两组患者在治疗中采用同样的治疗方案,即口服伊曲康唑的同时静脉注射卡泊芬净。经过为期六周的治疗,收集两组患者的全血样本,进行血液霉菌培养,统计肺曲霉菌病的阳性检出率。应用能谱CT进行复检,统计两组患者的治疗有效率。结果治疗前应用不同的方法进行检查,研究组的准确率显著高于对照组(P<0.05);经过治疗,两组患者血液霉菌培养的阳性检出率显著低于治疗前(P<0.05);采用能谱CT进行复检,研究组治疗有效率显著高于对照组(P<0.05)。结论在肺曲霉菌病的诊断与治疗中,能谱CT的运用能够有效提高诊断的准确率,对医生确定患者的治疗方案具有较大的帮助,在临床中有较大的应用价值。

Objective To explore the role of energy spectrum CT in the diagnosis and treatment of pulmonary aspergillosis. Methods From the 130 patients diagnosed with pulmonary aspergillosis by pathological biopsy from 2016 to 2017, 65 patients were selected as the control group, and only blood mold was used for re-examination. Another65 patients were selected as the study. In the group, in the re-examination, the energy spectrum CT was used as the basis of the control group. The same treatment regimen was used in the two groups of patients, ie, oral itraconazole was given intravenously with caspofungin. After a six-week treatment, whole blood samples from two groups of patients were collected, blood mold culture was performed, and the positive detection rate of pulmonary aspergillosis was counted. All patients applied energy spectrum CT for retest.The treatment efficiency of the two groups of patients was counted. Results The different methods were used before the treatment. The accuracy of the study group was significantly higher than that of the control group(P<0.05). After treatment, the positive detection rate of blood mold culture in the two groups was significantly lower than that before treatment(P<0.05). The reproducibility of the study group was significantly higher than that of the control group(P<0.05). Conclusion In the diagnosis and treatment of pulmonary aspergillosis, the use of energy spectrum CT can effectively improve the accuracy of diagnosis, and it is of great help to doctors to determine the treatment plan of patients, and has great application value in clinical.