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多层螺旋CT在侵袭性肺曲霉菌感染病情和预后预测的价值分析 被引量:3

Value of multi-slice spiral CT in prediction of illness condition and prognosis of invasive pulmonary Aspergillus infection
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摘要 目的观察和分析多层螺旋CT(MSCT)在侵袭性肺曲霉菌感染病情和预后预测中的价值,为制定合理临床诊疗方案提供客观依据。方法选取2014年3月-2016年7月的疑似侵袭性肺曲霉菌感染患者80例为研究对象,确诊为侵袭性肺曲霉菌感染59例,以病理学及痰培养为诊断金标准,对MSCT在侵袭性肺曲霉菌感染诊断中的价值进行评价;对确诊为侵袭性肺曲霉菌感染患者的病灶部位分布进行观察和分析;对合并侵袭性肺曲霉菌感染的血液病与非血液病患者的MSCT征象进行观察和比较;对所有确诊患者进行为期6周的随访,将临床症状明显改善患者列为预后良好组,将临床症状恶化或死亡的患者列为预后不良组,对两组患者治疗前及治疗6周时的MSCT表现进行分析和比较。结果 MSCT诊断侵袭性肺曲霉菌感染的灵敏度为93.2%、特异度为76.2%、阳性预测值为91.7%、阴性预测值为80.0%;侵袭性肺曲霉菌感染患者MSCT下病灶部位多为双肺多发,占42.4%,在肺叶分布中,以上叶分布为主,占55.9%,外周带分布较多,占69.5%;合并侵袭性肺曲霉菌感染的血液病患者的实变影和团块影的分布率显著高于非血液病患者,差异有统计学意义(P〈0.05);在治疗6周时,预后不良组患者各类MSCT征象的出现率均高于预后良好组,差异均有统计学意义(P〈0.05)。结论 MSCT在侵袭性肺曲霉菌感染辅助诊断中具有一定价值,患者的CT征象与其基础疾病、预后情况具有一定的相关性,可作为评价病情和预测预后的辅助手段。 OBJECTIVE To observe and analyze the value of multi-slice spiral CT(MSCT)in prediction of illness condition and prognosis of invasive pulmonary Aspergillusinfection so as to provide objective basis for clinical diagnosis and treatment.METHODS A total of 80 patients with suspected invasive pulmonary Aspergillus infection who were treated in the hospital from Mar 2014 to Jul 2016 were recruited as the study objects,and 59 patients were diagnosed with invasive pulmonary Aspergillusinfection.The pathology and sputum culture were used as the gold standards for diagnosis,the value of MSCT in diagnosis of invasive pulmonary Aspergillus infection was evaluated,and the distribution of lesion sites of the patients with invasive pulmonary Aspergillusinfection was observed and analyzed.The MSCT signs were observed and compared between the blood disease patients complicated with invasive pulmonary Aspergillus infection and the non-blood disease patients;a six-week follow-up was conducted for all of the confirmed cases,the patients whose clinical symptoms were remarkably improved were assigned as the favorable prognosis group,the patients whose clinical symptoms deteriorated or who died were set as the poor prognosis group,and the MSCT manifestations were observed and compared between the two groups of patients before the treatment and after the treatment for 6 weeks.RESULTS The sensitivity of the MSCT was93.2%in the diagnosis of invasive pulmonary Aspergillusinfection,the specificity 76.2%,the positive predictive value 91.7%,the negative predictive value 80.0%.The MSCT showed that lesions of the patients with invasive pulmonary Aspergillus infection were multiple lung lobes,accounting for 42.4%,the upper lobes were dominant among the lung lobes,accounting for 55.9%,of which 69.5% were peripheral zones.The distribution rates of consolidation shadows and mass shadows of the blood disease patients complicated with invasive pulmonary Aspergillus infection were significently higher than those of the non-blood disease patients�
作者 崔喜民 郭士伟 喻骏 黄成 贾英军 CUI Xi-min, GUO Shi-wei, YU Jun, HUANG Cheng, JIA Ying-jun (General Hospital of Armed Police Force in Jilin Province, Changchun, Jilin 130000, China)
出处 《中华医院感染学杂志》 CSCD 北大核心 2017年第9期1990-1993,共4页 Chinese Journal of Nosocomiology
基金 吉林省卫生厅科研基金资助项目(2014ZC007)
关键词 多层螺旋CT 侵袭性肺曲霉菌 感染 病情 预后 Multi-slice spiral CT Invasive pulmonary Aspergillus Infection Illness condition Prognosis
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