细菌感染性肺炎患者胸部CT征象及其与患者肺部炎症情况、预后的关系

Chest CT Signs of Patients with Bacterial Infectious Pneumonia and Their Relationship with Lung Inflammation and Prognosis

探讨细菌感染性肺炎患者的CT检查影像学特征与患者炎症病情、治疗结局的关系。选取100例经病原学检查明确诊断为细菌感染性肺炎的患者作为细菌组、同期100例经血清学等检查证实为病毒感染性肺炎的患者作为病毒组,对比两组患者病情进展期CT检查的影像学特征,根据患者病情危重程度将细菌组患者分为高危组和中危组,根据治疗28 d结局将细菌组患者分为存活组和死亡组,并对比肺部CT特征差异。在肺叶实变发生率、充气支气管征CT征象特征中,细菌组高于病毒组患者(P<0.05);肺部毛玻璃影特征检出结果比较,细菌组低于病毒组患者(P<0.05);高危组的肺叶实变、肺段实变、肺部毛玻璃影、胸腔积液、充气支气管征的发生率高于中危组患者(P<0.05);死亡组的肺叶实变、肺段实变、胸腔积液的发生率高于存活组患者(P<0.05);死亡组与存活组患者肺部毛玻璃影、网织条索、充气支气管征的发生率差异无统计学意义(P>0.05)。依据胸部CT检查特征,在一定程度上可以鉴定感染的病原体类型,对于细菌性肺炎患者的病情程度及预后评估有一定的参考价值。

Aim of this study was to investigate the relationship between CT imaging characteristics and inflammatory condition and treatment outcome in patients with bacterial infectious pneumonia.One hundred patients who were clearly diagnosed with bacterial infectious pneumonia by pathogenic examinations were selected as the bacterial group,and 100 patients with viral infectious pneumonia confirmed by serological examinations during the same period were selected as the virus group.The imaging characteristics of the two groups of patients in the advanced stage of the CT examination were compared.According to the critical condition of the patients,the bacterial group was divided into high-risk and intermediate-risk groups,and the bacterial group was divided into survival and death groups according to the 28-day treatment outcome,and compared Differences in lung CT features.In the incidence of lung lobe consolidation and CT signs of aerated bronchial sign,the bacterial group was higher than that of the virus group(P<0.05).As to the comparison of the detection results of ground glass shadow characteristics of the lungs,the bacterial group was lower than the virus group(P<0.05).The detection rate of lung lobe consolidation,lung segment consolidation,pulmonary ground glass shadow,pleural effusion,and air bronchial signs in the high-risk group were higher than those in the intermediate-risk group(P<0.05).The incidence of lung lobe consolidation,segment consolidation,and pleural effusion in the death group were higher than those in the survival group(P<0.05).The death group and the survival group had lung glass shadows,mesh strips,and air-filled bronchial signs.There was no statistically significant difference in incidence(P>0.05).According to the characteristics of chest CT examination,the type of pathogen can be identified to a certain extent,and it has certain reference value for the disease degree and prognosis evaluation of patients with bacterial pneumonia.