非结核分枝杆菌肺病的临床与MSCT表现

发布时间：2018-11-25 21:06

【摘要】：目的探讨非结核分枝杆菌(NTM)肺病的临床表现与MSCT特征。方法回顾性分析经临床和实验室检查确诊的102例NTM肺病和102例肺结核患者的病历资料与MSCT资料,两组间一般资料、CT征象的比较采用t/χ~2检验。结果 NTM肺病患者临床表现与肺结核类似,主要表现为咳嗽、咳痰、咯血和活动后气促,两组间差异无统计学意义(P均0.05)。NTM肺病常合并慢性肺部疾病,如肺结核病史、慢性阻塞性肺疾病、肺心病,与肺结核组比较,两组间差异均有统计学意义(P均0.05)。NTM肺病MSCT主要表现为小叶中心结节(89/102,87.25%)、支气管扩张(67/102,65.69%)、斑片状实变灶(64/102,62.75%),其次为纤维条索灶、薄壁空洞及胸膜增厚,其中小叶中心结节、支气管扩张、薄壁空洞的发生率高于肺结核组(χ~2=3.995、22.675、12.823,P均0.05),支气管扩张以右中叶和/或左舌叶明显。结论 NTM肺病常合并慢性肺部疾病,CT表现有一定特征性,尤其表现为右中叶和/或左舌叶支气管扩张伴周围小叶中心结节、薄壁空洞,具有以上CT特征且经正规抗结核效果不佳时,应考虑NTM肺病的可能。
[Abstract]:Objective to investigate the clinical manifestations and MSCT features of non-tuberculosis Mycobacterium (NTM) pulmonary disease. Methods the medical records and MSCT data of 102 cases of NTM pulmonary disease and 102 cases of pulmonary tuberculosis confirmed by clinical and laboratory examinations were retrospectively analyzed. The general data and CT signs of the two groups were compared by t / 蠂 ~ 2 test. Results the clinical manifestation of NTM pulmonary disease was similar to that of pulmonary tuberculosis. The main manifestations were cough, expectoration, hemoptysis and dyspnea after exercise. There was no significant difference between the two groups (P0. 05). NTM pulmonary disease often complicated with chronic pulmonary diseases, such as history of pulmonary tuberculosis). There were significant differences between the two groups in chronic obstructive pulmonary disease, cor pulmonale and pulmonary tuberculosis (P < 0. 05). NTM). The MSCT of pulmonary disease was mainly manifested as lobular central nodule (89 / 102, 87.25%). Bronchiectasis (67 / 102) (65.69%), patchy consolidation (64 / 102) (62.75%), followed by fibrous cord foci, thin-walled cavities and pleural thickening, including central lobular nodules, bronchiectasis, The incidence of thin-wall cavities was higher than that of pulmonary tuberculosis (蠂 ~ 2 ~ 2 ~ (3.995) 22.675 ~ (12.823) P 0.05). Bronchiectasis was found in the right middle lobe and / or left lingual lobe. Conclusion NTM's lung disease is often associated with chronic pulmonary disease. The CT features are characterized by right middle lobe and / or left lingual lobular bronchiectasis with peripheral central lobular nodule and parenchymal cavity. The possibility of NTM pulmonary disease should be considered when the above CT features and the antituberculous effect is not good.
【作者单位】：长沙市中心医院放射科;湖南省人民医院放射科;
【分类号】：R563;R816.41

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