胸部DR特征对尘肺合并肺结核的预后预测价值分析

Analysis of the Prognostic Predictive Value of Chest DR Features for Pneumoconiosis Combined with Pulmonary Tuberculosis

目的:探讨胸部DR特征对尘肺合并肺结核的预后预测价值。方法:选取本中心2019年1月~2022年1月诊断的50例尘肺合并肺结核患者进行回顾性分析,分析所有患者的胸部DR图像特征。通过患者最终随访结果将治疗结果不良的15例患者分为预后不良组,将治疗结果成功的35例患者分为预后良好组,分析胸部DR特征对尘肺合并肺结核的预后预测价值。结果:50例尘肺合并肺结核患者中,均呈现弥漫性分布的结节影。其中有14例患者出现空洞,有34例患者出现絮状阴影,2例患者出现双侧团状影不对称现象;预后不良组与预后良好组患者尘肺分期、是否重症、胸部DR显示发病部位、胸部DR显示结节密度均匀与分布均匀情况以及胸部DR显示空洞平均直径对比差异显著(P<0.05);Logistic回归分析结果表明:重症、胸部DR显示结节情况和胸部DR显示空洞平均直径为尘肺合并肺结核预后不良的独立影响因素(P<0.05)。结论:胸部DR特征对尘肺合并肺结核的图像特征具有一定差异性,同时可以辅助临床对患者预后情况进行预测,对于胸部DR显示结节密度、分布不均,空洞较大的患者要警惕预后不良现象,及时调整治疗方案。

Objective:To explore the prognostic value of chest DR features in pneumoconiosis complicated with pulmonary tuberculosis.Methods:Retrospective analysis was conducted on 50 cases of pneumoconiosis combined with pulmonary tuberculosis diagnosed in our center from January 2019 to January 2022,and the chest DR image features of all patients were analyzed.Based on the final follow-up results of the patients,15 patients with poor treatment outcomes were divided into a poor prognosis group,and 35 patients with successful treatment outcomes were divided into a good prognosis group.The prognostic value of chest DR characteristics for pneumoconiosis combined with pulmonary tuberculosis was analyzed.Results:Among 50 patients with pneumoconiosis combined with pulmonary tuberculosis,diffuse nodular shadows were present.Among them,14 patients had cavities,34 patients had flocculent shadows,and 2 patients had asymmetric bilateral nodular shadows;There were significant differences(P<0.05)between the poor prognosis group and the good prognosis group in terms of pneumoconiosis staging,severity,location of disease on chest DR,uniform density and distribution of nodules on chest DR,and average diameter of cavities on chest DR;The results of Logistic regression analysis showed that severe cases,nodules on chest DR,and average diameter of cavities on chest DR were independent influencing factors for poor prognosis of pneumoconiosis combined with pulmonary tuberculosis(P<0.05).Conclusion:The features of chest DR are different in the imaging features of pneumoconiosis complicated with pulmonary tuberculosis,and can be used to predict the prognosis of patients,patients with large voids should be alert to poor prognosis,timely adjustment of treatment.