免疫缺陷患者感染巨细胞病毒性肺炎的CT表现及临床诊疗价值

CT imaging findings of cytomegalovirus pneumonia in immunodeficient patients

目的探讨免疫缺陷患者感染巨细胞病毒性肺炎的肺部CT影像学特点。方法选取我院收治的60例肺部感染的免疫缺陷患者为观察对象,按照感染类型分为对照组和观察组,每组30例,观察对比两组患者的肺部CT特点。结果对比两组患者的CT特征发现,观察组患者在病灶数量、病灶结构、病灶质地、病灶厚度、迁移性感染等方面均多于对照组患者,差异具有统计学意义(P<0.05),而在分隔强化、脓腔积气等方面,差异无统计学意义(P>0.05);对比两组患者的病变形态发现,观察组患者在充气支气管征、小叶分布型毛玻璃样影、叶实变等方面均多于对照组患者,差异具有统计学意义(P<0.05),而在多发性小结节病灶、网织条索和毛玻璃样影、段实变等方面,差异无统计学意义(P>0.05);对比两组患者的分布特点发现,观察组患者在肺实质、肺间质等方面与对照组患者差异具有统计学意义(P<0.05),而在双侧肺、单侧多叶、单侧单叶等方面差异无统计学意义(P>0.05)。结论免疫缺陷患者易感染巨细胞病毒性肺炎,应在常规组织病理检查基础上结合影像学手段共同进行诊断。

Objective To explore the imaging features and clinical value of cytomegalovirus pneumonia in immunodeficiency patients.Methods 60 immunodeficient patients with pulmonary infection admitted to our hospital from April 2016 to April 2018 were selected as the research objects.According to the type of infection,they were divided into control group and observation group,with 30 cases in each group.The pulmonary CT characteristics of the two groups were observed and compared.Results Comparing the CT features of the two groups,it was found that the number,structure,texture,thickness and migratory infection of the lesions in the observation group were more than those in the control group(P<0.05),but there was no significant difference in segregation enhancement and empyema(P>0.05).Compared with the control group,the patients in the observation group had more pneumatic bronchial sign,lobular distribution ground glass opacity and consolidation of lobes(P<0.05),but there was no significant difference in multiple nodules,reticular strips,ground glass opacity and segment consolidation(P>0.05).Comparing the distribution characteristics of the two groups,it was found that the patients in the observation group had no significant difference in lung parenchyma and consolidation of lobules(P>0.05).There were significant differences in interstitial and other aspects between the two groups(P<0.05),but there were no significant differences in bilateral lung,unilateral Multilobe and unilateral unilobe(P>0.05).Conclusion Immunodeficiency patients are susceptible to cytomegalovirus pneumonia and should be diagnosed on the basis of routine histopathological examination combined with imaging methods.Because the sample size chosen in this study is small and may not be typical,there are differences in the specific imaging manifestations of immunodeficient patients infected with CMVP.More in-depth study is needed to find out the imaging characteristics of CMVP as soon as possible.