儿童麻疹肺部感染的影像学表现与PCT相关性

发布时间：2018-07-04 19:08

本文选题：儿童 + 麻疹　；参考：《临床放射学杂志》2017年10期

【摘要】：目的探讨儿童麻疹肺部感染两种类型的影像学表现,提高和重视对这一疾病的认识和诊断水平。方法回顾分析82例儿童麻疹肺部感染的影像学表现,结合临床资料等,将肺部感染分为麻疹肺炎和麻疹合并肺炎两种类型,并就两种感染类型的CRP和PCT等检验指标进行统计学分析。结果 (1)麻疹肺炎(50例)。X线胸片:肺气肿31例,肺纹理增多、模糊39例,肺门增大8例,磨玻璃影2例,典型麻疹肺炎22例。CT扫描8例,3例表现为两下肺散在点片状模糊影,1例表现为左舌叶小片状影伴左侧胸膜增厚,1例为右上肺及左下肺的小片状影,其余3例CT检查正常。(2)麻疹合并肺炎(32例)。X线胸片:两肺纹理增多、模糊20例,肺门增大4例,小叶性麻疹合并肺炎9例,多肺段或大叶性肺实变23例,磨玻璃影4例,气胸及纵隔皮下气肿3例。CT扫描7例,包括两肺多发片絮状影3例,两肺大片状实变影4例,伴发磨玻璃影4例,气胸及纵隔皮下气肿3例,其中1例合并心包积气。(3)采用Mann-Whitney U检验,结果显示,CRP在麻疹肺炎与麻疹合并肺炎、典型麻疹肺炎与小叶性麻疹合并肺炎之间指标Z差异无统计学意义。PCT在麻疹肺炎与麻疹合并肺炎、典型麻疹肺炎与小叶性麻疹合并肺炎之间指标Z差异有统计学意义(P0.001)。结论儿童麻疹肺部感染两种类型的影像学表现具有一定的特征,结合CRP及PCT等检验指标分析,有助于提高对两者的认识和鉴别水平。对于提高诊断水平和指导临床治疗及疗效评估有重要意义。
[Abstract]:Objective to investigate the imaging manifestations of two types of measles pulmonary infection in children, and to improve the recognition and diagnosis of the disease. Methods the imaging findings of 82 children with measles pulmonary infection were retrospectively analyzed. Combined with clinical data, pulmonary infection was divided into two types: measles pneumonia and measles combined with pneumonia. The CRP and PCT of two types of infection were analyzed statistically. Results (1) chest radiographs of 50 cases of measles pneumonia: 31 cases of emphysema, 39 cases of pulmonary texture, 39 cases of blur, 8 cases of enlargement of hilum, 2 cases of vitreous opacity. 22 cases of typical measles pneumonia. Ct scan in 8 cases, 3 cases showed two inferior lung scattered in the spot flaky blur shadow. 1 case showed left lobular flake shadow with left pleural thickening. 1 case showed small flake shadow of right upper lung and left lower lung, and 1 case showed small slice shadow of right upper lung and left lower lung. The rest 3 cases had normal CT examination. (2) chest radiographs of measles complicated with pneumonia (32 cases). X ray chest film showed that there were 20 cases of enlargement of both lungs, 4 cases of enlargement of hilum, 9 cases of lobular measles complicated with pneumonia, 23 cases of multisegmental or lobar pulmonary consolidation, 4 cases of glass opacity. 3 cases of pneumothorax and mediastinal subcutaneous emphysema. Ct scan included 3 cases of flocculent film of two lungs, 4 cases of large flake solid shadow of two lungs, 4 cases of vitreous opacification, 3 cases of pneumothorax and mediastinal subcutaneous emphysema, 3 cases of pneumothorax and mediastinal subcutaneous emphysema. (3) Mann-Whitney U test was performed in 1 case with pericardial accumulation of qi. The results showed that CRP was detected in measles pneumonia and measles complicated pneumonia. There was no significant difference in Z between SARS and lobular measles complicated pneumonia. PCT was statistically significant between measles pneumonia and measles complicated pneumonia, and between typical measles pneumonia and lobular measles complicated pneumonia (P0.001). Conclusion the imaging findings of two types of children with measles pulmonary infection have certain characteristics. The analysis of CRP and PCT is helpful to improve the recognition and differential level of the two types. It is of great significance to improve the diagnostic level and guide the clinical treatment and evaluation of curative effect.
【作者单位】：东南大学附属第二医院放射科;
【分类号】：R725.1;R816.92

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