CAJ | 학술논문

目的：通过建立动物模型探讨不同免疫状态及感染途径下肺白念珠菌病急性期CT表现的演变规律及其与病理学改变的关系。方法将40只新西兰大白兔分为四组分别建立免疫正常及免疫抑制状态下原发及继发性肺念珠菌病模型，接种后隔日一次行CT扫描并动态观察各组兔肺部CT 表现，并与尸检病理结果对照。结果成功建立兔肺念珠菌病模型23例，C T表现混合型病变（16/23），弥漫性（14/23）分布为主，包括磨玻璃影19例，呈弥漫性分布7例，多发片状分布9例，局灶性分布3例；实变影11例，其中弥漫性分布5例，多发片状分布5例，单发1例；结节影10例，8例结节首次出现以分布于外周带为主，其中6例逐渐向中央带进展呈弥漫性分布，2例无明显进展趋势；2例分布于支气管血管束周围。病理表现为渗出性或增殖性肺泡损伤和/或间质炎症19例，出血性坏死9例，血管栓塞8例，肉芽肿性炎症3例。结论肺念珠菌病急性期CT表现的演变规律具有一定的特点。
목적：통과건립동물모형탐토불동면역상태급감염도경하폐백념주균병급성기CT표현적연변규률급기여병이학개변적관계。방법장40지신서란대백토분위사조분별건립면역정상급면역억제상태하원발급계발성폐념주균병모형，접충후격일일차행CT소묘병동태관찰각조토폐부CT 표현，병여시검병리결과대조。결과성공건립토폐념주균병모형23례，C T표현혼합형병변（16/23），미만성（14/23）분포위주，포괄마파리영19례，정미만성분포7례，다발편상분포9례，국조성분포3례；실변영11례，기중미만성분포5례，다발편상분포5례，단발1례；결절영10례，8례결절수차출현이분포우외주대위주，기중6례축점향중앙대진전정미만성분포，2례무명현진전추세；2례분포우지기관혈관속주위。병리표현위삼출성혹증식성폐포손상화/혹간질염증19례，출혈성배사9례，혈관전새8례，육아종성염증3례。결론폐념주균병급성기CT표현적연변규률구유일정적특점。
Objective To investigate the developing tendency of CT findings and pathological findings in pulmonary can-didiasis at acute stage ,by establishing animals model of different immune status and different infective routes .Methods Forty New Zealand rabbits were divided into four groups randomly (A ,B ,C ,D) for establishing animals model of prima-ry and secondary pulmonary candidiasis in immunocompetent and immunosuppressed status .Chest CT scan was performed before and on alternative days after inoculation/injection .Microbiological and pathological results were obtained by autop-sy .Results Pulmonary candidiasis was successfully established in 23 rabbits confirmed by microbiology and pathology . Lesions in each group were mixed pattern (16/23) and mainly in diffuse distribution (14/23) .The main CT findings were GGO (19/23) ,which showed diffuse distribution in 7 cases ,multiple patchy in 9 cases ,focal distribution in 3 cases ,fol-lowed by consolidation (11/23) ,which showed diffuse distribution in 5 cases ,multiple patchy in 5 cases ,focal distribution in 1 case .Nodules present in 10 cases ,in which 8 cases mainly distributed in the peripheral zone with spread into the cen-tral zone in 2 cases and no tendency to progress in 2 cases of nodules were distributed around the bronchovascular bundles . Pathological findings corresponded to the exudative or proliferative phase of diffuse alveolar inflammation or interstitial hy-perplasia in 19 cases ,well-defined hemorrhagic infarcts in 9 cases ,thrombus in 8 cases ,and granulomatous inflammation in 3 cases .Conclusion Developing tendency of CT findings in pulmonary candidiasis at acute stage had certain characteris-tics .