胸部CT结合床旁气管镜对侵袭性肺曲霉病的早期诊断价值研究

Value of Chest CT Combined with Bedside Bronchoscopy in Early Diagnosis of Invasive Pulmonary Aspergillosis(IPA)

目的 探讨胸部CT结合床旁气管镜在侵袭性肺曲霉病(IPA)诊断中的应用价值。方法 回顾性选取2015年1月至2021年7月在我院就诊的IPA临床诊断患者63例,根据病理结果将IPA确诊患者作为观察组,非IPA确诊患者作为对照组,分析两组胸部CT、气管镜征象差异,同时分析胸部CT联合气管镜诊断IPA确诊患者的价值。结果 63例IPA临床诊断患者中,经病理学确诊IPA患者51例,非IPA患者12例;观察组胸部CT征象新月征、晕轮征比例分别为37.25%和41.18%,明显高于对照组(P<0.05);观察组气管镜下粘膜白斑、黑斑比例为62.75%,明显高于对照组(P<0.05);胸部CT联合床旁气管镜诊断IPA确诊患者的灵敏性、特异性、准确率、阳性预测值和阴性预测值分别为92.16%、75.00%、88.89%、90.00%和69.23%。结论 胸部CT结合床旁气管镜早期诊断IPA有较好的临床应用价值。

Objective To explore the value of chest CT combined with bedside bronchoscopy in the diagnosis of invasive pulmonary aspergillosis(IPA).Methods 63 patients with IPA diagnosed in our hospital from January 2015 to July 2021 were selected retrospectively,according to the pathological results,the patients with IPA were taken as the observation group and the patients without IPA were taken as the control group,the differences of chest CT and tracheoscopy between the two groups were analyzed,and the value of chest CT combined with tracheoscopy in the diagnosis of IPA was analyzed.Results Among 63 patients with IPA,51 patients were diagnosed with IPA by pathology and 12 patients were not diagnosed with IPA.The proportions of crescent sign and halo sign in the observation group were 37.25%and 41.18%respectively,compared with control group,which was significantly higher(P<0.05).The proportion of leukoplakia and black spots in the observation group was 62.75%,compared with control group,which was significantly higher t(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of chest CT combined with bedside bronchoscopy in the diagnosis of IPA were 92.16%,75.00%,88.89%,90.00%and 69.23%respectively.Conclusion Chest CT combined with bedside bronchoscopy has good application value in early diagnosis of IPA,is worthy of clinical use.