发病时间对初治肺结核空洞类型及痰涂片结果的影响

The effects of onset time on cavity types and sputum smear results of initial-treated pulmonary tuberculosis

目的探讨发病时间对初治肺结核空洞类型及痰涂片结果的影响。方法收集2016年1月~2017年4月初治肺结核住院且行胸部CT检查患者共计461例,其中合并空洞174例(37.7%),根据主诉将发病时间(从出现症状至临床确诊的时间间隔)分为三组,即小于1个月为组I(180例)、1~3个月为组II(135例),大于等于3个月为组III(146例),根据痰涂片结果分为阳性组(125例)及阴性组(336例),对于分类资料的统计分析采用X^2检验。结果组I~组III空洞合并率依次为24.7%、31.6%及43.7%;其中厚壁空洞类型率依次降低,即44.8%、34.5%、20.7%,而虫蚀样空洞及虫蚀样+厚壁混合性空洞类型率依次升高,分别为30.2%、32.1%、37.7%及20.6%、26.5%、52.9%。组I~组III痰涂片阳性率依次为24.0%、32.8%、43.2%;厚壁空洞、虫蚀样空洞及厚壁+虫蚀样混合性空洞类型痰涂片阳性率分别为40.2%、35.8%、58.8%。是否合并空洞及痰涂片结果在组I vs组II、组I vs组III中具有统计学差异(P<0.05),而空洞类型在组I vs组III、组II vs组III中具有统计学差异(P<0.05)。结论随着发病时间延长,初治肺结核空洞合并率、含虫蚀样空洞类型率及痰涂片阳性率均逐渐升高,且是否合并空洞及不同空洞类型与痰涂片结果相关。

Objective To explore the effects of onset time on cavity types and sputum smear results of initial-treated pulmonary tuberculosis.Methods A total of 461 patients with initial-treated pulmonary tuberculosis who underwent chest CT examination from January 2016 to April 2017 were enrolled,including 174 patients(37.7%)with merging cavity.According to the main complaint,the onset time(defined as time interval between the onset of symptoms and being diagnosed)was divided into three groups less than 1 month for group I(180 cases),1 to 3 months for group II(135 cases),and more than or equal to 3 months for group III(146 cases).And according to the results of sputum smear,it was divided into positive group(125 cases)and negative group(336 cases).For the statistical analysis of classified data,X^2 test was used.Results The cavity rates of group I to group III was 24.7%,31.6%and 43.7%,respectively.The rate of thick-walled cavity decreased sequentially,which was 44.8%,34.5%,and 20.7%.While the rate of worm-eaten and worm-eaten and thick-walled mixed-type cavity increased in turn,was 30.2%,32.1%,37.7%and 20.6%,26.5%,52.9%,respectively.The positive rates of sputum smear from group I to III was 24.0%,32.8%and 43.2%,respectively.The positive rate of sputum smear results of thick-walled cavity,mouth-eaten cavity,thick-walled and mouth-eaten mixed cavity was 40.2%,35.8%,58.8%,respectively.Whether to merge cavity and sputum smear results showed significant difference in group I vs group II,group I vs group III(P<0.05),while different cavity types showed significant differences in group I vs group III,group II vs group III(P<0.05).Conclusion With the prolonged duration of disease,the cavity merging rate,the rate of contains worm-eaten cavity types and the positive rate of sputum smears are gradually increased.Furthermore,whether merged cavity and different cavity types are related to the sputum smear results.