多层螺旋CT常规及高分辨扫描对矽肺合并下呼吸道感染的诊断价值

Diagnostic value of conventional scanning and high-resolution scanning of multi-slice spiral CT on silicosis patients with lower respiratory infection

目的探讨多层螺旋CT常规扫描及高分辨扫描对矽肺患者合并下呼吸道感染的诊断价值。方法将80例矽肺疑似合并下呼吸道感染患者设为研究对象,收集患者痰液进行细菌培养及鉴定,对患者分别行多层螺旋CT常规扫描及高分辨扫描,分析其诊断价值。结果入组患者中73例确诊为合并下呼吸道感染,确诊患者痰液培养出病原菌78株,其中革兰阴性菌43株,占55.13%,革兰阳性菌33株,占42.31%,真菌2株,占2.56%。多层螺旋CT常规扫描对矽肺合并下呼吸道感染诊断敏感度为71.23%,特异度为28.57%,诊断符合率为67.50%;多层螺旋CT高分辨扫描对矽肺合并下呼吸道感染诊断敏感度为94.52%,特异度为85.71%,诊断符合率为93.75%。多层螺旋CT高分辨扫描诊断矽肺合并下呼吸道感染的敏感度、特异度、诊断符合率显著高于常规扫描(P<0.05)。结论革兰阴性菌是引起矽肺合并下呼吸道感染的主要病原菌,多层螺旋CT高分辨扫描对矽肺患者合并下呼吸道感染的诊断价值较高,对病情早期诊断具有重要意义。

Objective To investigate the diagnostic value of conventional scanning and high-resolution scanning of multi-slice spiral CT on silicosis patients with lower respiratory infection.Methods A total of 80 patients with suspected silicosis complicated with lower respiratory infection were selected as the study subjects.The sputum of patients was collected for bacterial culture and identification.Conventional scanning and high-resolution scanning of multi-slice spiral CT were performed on the patients,respectively,and their diagnostic value was analyzed.Results Among the enrolled patients,73 were diagnosed with lower respiratory infection.78 strains of pathogenic bacteria were cultured in the sputum of confirmed patients,including 43 strains of gram-negative bacteria,accounting for 55.13%,33 strains of gram-positive bacteria,accounting for 42.31%,and 2 strains of fungi,accounting for 2.56%.The sensitivity,specificity and diagnostic coincidence rate of conventional scanning of multi-slice spiral CT in the diagnosis of silicosis complicated with lower respiratory infection were 71.23%,28.57% and 67.50%,respectively.The sensitivity,specificity and diagnostic coincidence rate of high-resolution scanning of multi-slice spiral CT in the diagnosis of silicosis complicated with lower respiratory infection were 94.52%,85.71% and 93.75%,respectively.The sensitivity,specificity and diagnostic coincidence rate of high-resolution scanning of multi-slice spiral CT in the diagnosis of silicosis complicated with lower respiratory tract infection were significantly higher than those of conventional scanning(P<0.05).Conclusions Gram-negative bacteria are the main pathogens causing silicosis complicated with lower respiratory infection.High-resolution scanning of multi-slice spiral CT has high diagnostic value for patients with silicosis complicated with lower respiratory infection,and is of great significance for early diagnosis of the disease.