中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2015年
10期
745-749
,共5页
显微镜下多血管炎%肺炎%体层摄影术,X线计算机
顯微鏡下多血管炎%肺炎%體層攝影術,X線計算機
현미경하다혈관염%폐염%체층섭영술,X선계산궤
Microscopic polyangitis%Pneumonia%Tomography,X-ray computed
目的 探讨显微镜下多血管炎(MPA)合并肺感染的胸部CT表现及实验室检查特点.方法 回顾性分析42例临床确诊为MPA患者的临床资料和胸部CT表现.根据痰培养结果,将患者分为MPA合并肺感染组(16例)及单纯MPA组(26例),对比分析两组间胸部CT表现和实验室检查的差异.统计学方法采用χ2检验、Fisher精确检验、独立样本t检验和Mann-Whitney U检验.结果与单纯MPA组相比,MPA合并肺感染组的胸部CT更多表现为斑片影(两组分别为15、14例,χ2=5.631,P=0.018)和实变影(两组分别为7、2例,χ2=5.657,P=0.017),且MPA合并肺感染组的斑片影(6例)较单纯MPA组(12例)更少表现为外周带分布(P=0.021),两组间差异均有统计学意义;而磨玻璃影、胸腔积液、淋巴结增大及间质纤维化等表现在两组间差异均无统计学意义(P值均>0.05);此外, MPA合并肺感染组中性粒细胞比例(0.84±0.12)高于单纯MPA组(0.74±0.11),差异具有统计学意义(t=2.845,P=0.007),而白细胞、中性粒细胞、红细胞沉降率、抗髓过氧化物酶抗体值及C反应蛋白等数据在两组间差异均无统计学意义(P值均>0.05).结论 与单纯MPA患者相比,MPA合并肺感染患者更多表现为斑片影和实变影,中性粒细胞比例更高.临床中具有上述表现的MPA患者,应警惕肺感染可能,积极进行痰培养并进行针对性抗感染治疗.
目的 探討顯微鏡下多血管炎(MPA)閤併肺感染的胸部CT錶現及實驗室檢查特點.方法 迴顧性分析42例臨床確診為MPA患者的臨床資料和胸部CT錶現.根據痰培養結果,將患者分為MPA閤併肺感染組(16例)及單純MPA組(26例),對比分析兩組間胸部CT錶現和實驗室檢查的差異.統計學方法採用χ2檢驗、Fisher精確檢驗、獨立樣本t檢驗和Mann-Whitney U檢驗.結果與單純MPA組相比,MPA閤併肺感染組的胸部CT更多錶現為斑片影(兩組分彆為15、14例,χ2=5.631,P=0.018)和實變影(兩組分彆為7、2例,χ2=5.657,P=0.017),且MPA閤併肺感染組的斑片影(6例)較單純MPA組(12例)更少錶現為外週帶分佈(P=0.021),兩組間差異均有統計學意義;而磨玻璃影、胸腔積液、淋巴結增大及間質纖維化等錶現在兩組間差異均無統計學意義(P值均>0.05);此外, MPA閤併肺感染組中性粒細胞比例(0.84±0.12)高于單純MPA組(0.74±0.11),差異具有統計學意義(t=2.845,P=0.007),而白細胞、中性粒細胞、紅細胞沉降率、抗髓過氧化物酶抗體值及C反應蛋白等數據在兩組間差異均無統計學意義(P值均>0.05).結論 與單純MPA患者相比,MPA閤併肺感染患者更多錶現為斑片影和實變影,中性粒細胞比例更高.臨床中具有上述錶現的MPA患者,應警惕肺感染可能,積極進行痰培養併進行針對性抗感染治療.
목적 탐토현미경하다혈관염(MPA)합병폐감염적흉부CT표현급실험실검사특점.방법 회고성분석42례림상학진위MPA환자적림상자료화흉부CT표현.근거담배양결과,장환자분위MPA합병폐감염조(16례)급단순MPA조(26례),대비분석량조간흉부CT표현화실험실검사적차이.통계학방법채용χ2검험、Fisher정학검험、독립양본t검험화Mann-Whitney U검험.결과여단순MPA조상비,MPA합병폐감염조적흉부CT경다표현위반편영(량조분별위15、14례,χ2=5.631,P=0.018)화실변영(량조분별위7、2례,χ2=5.657,P=0.017),차MPA합병폐감염조적반편영(6례)교단순MPA조(12례)경소표현위외주대분포(P=0.021),량조간차이균유통계학의의;이마파리영、흉강적액、림파결증대급간질섬유화등표현재량조간차이균무통계학의의(P치균>0.05);차외, MPA합병폐감염조중성립세포비례(0.84±0.12)고우단순MPA조(0.74±0.11),차이구유통계학의의(t=2.845,P=0.007),이백세포、중성립세포、홍세포침강솔、항수과양화물매항체치급C반응단백등수거재량조간차이균무통계학의의(P치균>0.05).결론 여단순MPA환자상비,MPA합병폐감염환자경다표현위반편영화실변영,중성립세포비례경고.림상중구유상술표현적MPA환자,응경척폐감염가능,적겁진행담배양병진행침대성항감염치료.
Objective To investigate the imaging features of chest CT and characteristics of laboratory tests in microscopic polyangitis (MPA) with pulmonary infection. Methods Based on the results of sputum culture, 42 patients with MPA were divided into two groups, MPA with pulmonary infection (16 cases)and MPA without pulmonary infection (26 cases). The results of chest CT images and laboratory tests were compared between the 2 groups by χ2 test (or Fisher exact test) and student t test (or Mann-Whitney U test), respectively. Results Compared with patients without pulmonary infection, patients with pulmonary infection showed patchy opacities(15/16 cases versus 14/26 cases,χ2=5.631,P=0.018)and consolidations(7/16 cases versus 2/26 cases,χ2=5.657,P=0.017)more frequently. Patchy opacities showed peripheral distribution less frequently in the MPA with pulmonary infection group than in the MPA without pulmonary infection group (6/15cases versus 12/14 cases,P=0.021). Patients with pulmonary infection showed the same frequent as the patients without pulmonary infection in the following CT findings including ground glass opacities, pleural effusions, mediastinal adenopathy and pulmonary fibrosis (P>0.05). The MPA with pulmonary infection group had higher neutrophil ratio than the MPA without pulmonary infection group (0.84 ± 0.12 versus 0.74 ± 0.11,t= 2.845,P= 0.007). Conclusions The MPA patients with pulmonary infection show patchy opacities and consolidations more frequently, and have higher neutrophil ratio than the MPA without pulmonary infection. The characteristics can be helpful in the diagnosis of pulmonary infection in the MPA patients and guild the treatment.
