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目的分析中青年人初治耐多药肺结核患者的CT表现,探讨其影像学特点。方法回顾性分析2013年1月至2014年12月本院经药敏试验证实的28例中青年人耐多药(观察组)及同期84例中青年人非耐药(对照组)肺结核患者的CT影像资料;运用统计学方法检验两组间影像表现差异。结果两组间具有统计学意义的CT表现:(1)观察组少于对照组:病灶内钙化(χ~2=5.60,P<0.025);(2)观察组多于对照组:肺毁损(χ~2=11.03,P<0.005)、胸膜钙化(χ~2=16.85,P<0.005)、脓气胸(χ~2=14.54,P﹤0.005)、支气管扩张(χ~2=8.82,P<0.01)。两组间无统计学意义的CT表现(P>0.05):斑片灶(χ~2=0.39)、结节灶(χ~2=0.9)、斑条灶(χ~2=2.68)、播散灶(χ~2=0.63)、空洞分布(χ~2=0.018)、多发空洞(χ~2=0.59)、空洞内液平(χ~2=0.11)、胸腔积液(χ~2=1.96)、纵隔肺门淋巴结肿大(χ~2=2.09)、纵隔肺门淋巴结钙化(χ~2=0.72)。结论两组患者病灶内钙化的差异具有统计学意义(P<0.025);在肺毁损、胸膜钙化、脓气胸、支气管扩张的征象上差异具有显著统计学意义(P<0.01)。在CT诊断肺结核时,除斑片、结节、斑条、播散灶及多发空洞、胸腔积液等结核征象外,如存在肺毁损、胸膜钙化、脓气胸、支气管扩张等征象,要高度怀疑为耐多药肺结核。
Objective To analyze the CT manifestations of MDR-TB patients in young and middle-aged patients and discuss their imaging features. Methods A retrospective analysis was performed on 28 MDR-MDR patients (observation group) and 84 non-drug-resistant (control group) tuberculosis patients admitted to our hospital from January 2013 to December 2014 in our hospital. CT images; using statistical methods to test the difference between the two groups of imaging performance. Results There were statistically significant CT findings between the two groups: (1) the observation group was less than the control group, the lesion calcification (χ ~ 2 = 5.60, P <0.025); (2) The observation group was more than the control group pleural pneumonitis (χ ~ 2 = 11.03, P <0.005), pleural calcification (χ ~ 2 = 16.85, P <0.005) 0.01). No significant difference was found between the two groups (P> 0.05): patch lesions (χ ~ 2 = 0.39), nodules (χ ~ 2 = 0.9) (Χ ~ 2 = 0.11), pleural effusion (χ ~ 2 = 0.63), cavity distribution (χ ~ 2 = 1.96), mediastinal hilar lymph nodes (χ ~ 2 = 2.09), mediastinal hilar lymph nodes calcification (χ ~ 2 = 0.72). Conclusion There is a significant difference in calcification between the two groups (P <0.025). There is significant difference in the signs of lung injury, pleural calcification, pus pneumothorax and bronchiectasis (P <0.01). CT in the diagnosis of tuberculosis, in addition to patches, nodules, plaques, disseminated lesions and multiple holes, pleural effusion and other signs of tuberculosis, such as the existence of lung damage, pleural calcification, pus pneumothorax, bronchiectasis and other signs, to be highly suspected For multidrug-resistant pulmonary tuberculosis.