摘要
目的探讨儿童耐药肺结核患者的CT特征。方法收集广州市胸科医院2012年1月至2018年12月经临床及实验室确诊的儿童耐药肺结核29例为耐药肺结核组(DR组);采用1∶3病例对照研究,选取同期符合纳入标准的对抗结核药物敏感的结核病患儿87例,归为敏感组(DS组)。匹配原则为同性别、年龄±2岁。两组患儿按照年龄将0~岁患儿分为耐药1组(DR1组)12例、敏感1组(DS1组)36例,将5~14岁患儿分为耐药2组(DR2组)17例、敏感2组(DS2组)51例,对比分析不同年龄段对抗结核药物耐药患儿与敏感患儿的CT特征,总结耐药结核病儿童的CT表现特征。结果DR1组与DS1组、DR2组与DS2组的肺内病灶累及双肺各叶的发生率分别为66.67%(8/12)和30.56%(11/36)、52.94%(9/17)和23.53%(12/51),差异均有统计学意义(χ^2值分别为4.907、5.167,P值分别为0.027、0.023)。DR1组及DS1组肺内多发结节状病灶的发生率分别为83.33%(10/12)、44.44%(16/36),肺实变发生率分别为50.00%(6/12)、86.11%(31/36),出现胸腔积液者分别为8.33%(1/12)、38.89%(14/36),支气管狭窄发生率分别为16.67%(2/12)、52.78%(19/36),差异均有统计学意义(χ^2值分别为5.483、6.644、3.911、4.769,P值分别为0.019、0.010、0.048、0.029)。DR2组及DS2组胸腔积液的发生率分别为11.76%(2/17)、43.14%(22/51),支气管狭窄的发生率分别为47.06%(8/17)、21.57%(11/51),两组比较差异均有统计学意义(χ^2值分别为5.495、4.115,P值分别为0.019、0.043)。结论DR组的CT特征是肺内病变范围较DS组广泛;0~岁年龄组的耐药肺结核患儿的肺内以多发结节状病灶常见;5~14岁年龄组的耐药肺结核患儿的支气管狭窄发生率较高。
Objective To investigate the CT imaging features of drug-resistant tuberculosis(DR-TB)in children.Methods A total of 29 children with DR-TB in Guangzhou Chest Hospital diagnosed by clinical and laboratory from January 2012 to December 2018 were retrospectively collected as DR-TB group(Group DR).Meanwhile,based on 1:3 case-control study,87 children in the same period with drug-sensitive tuberculosis(DS-TB)who met the inclusion criteria were selected as drug-sensitive group(Group DS).The principle of comparative matching was the same sex and age±2 years old.In these two groups,the children aged 0-years old were classified into Drug-resistant Group 1(Group DR1,12 cases),and Drug-sensitive Group 1(Group DS1,36 cases);the children aged 5-14 years old were classified into Drug-resistant Group 2(Group DR2,17 cases),and Drug-sensitive Group 2(Group DS2,51 cases).The CT features of drug-resistant children and drug-sensitive children in different age groups were compared and analyzed,and the CT features of DR-TB children were summarized.Results The incidence of lesions involving lobes of both lungs in Group DR1 and Group DS1,Group DR2 and Group DS2 was 66.67%(8/12)and 30.56%(11/36),52.94%(9/17)and 23.53%(12/51),respectively.There were significantly differences between the two groups(χ^2 values:4.907,and 5.167,respectively;Pvalues:0.027 and 0.023,respectively).The incidence of multiple nodular lesions in Group DR1 and Group DS1 was 83.33%(10/12)and 44.44%(16/36),respectively,and that of consolidation was 50.00%(6/12)and 86.11%(31/36),that of pleural effusion was 8.33%(1/12)and 38.89%(14/36),that of bronchostenosis was 16.67%(2/12)and 52.78%(19/36),respectively.There were significantly differences in these aspects between the two groups(χ^2 values:5.483,6.644,3.911,and 4.769,respectively;P values:0.019,0.010,0.048,and 0.029,respectively).The incidence of pleural effusion in Group DR2 and Group DS2 was 11.76%(2/17)and 43.14%(22/51),respectively,and that of bronchostenosis was 47.06%(8/17)and 21.57%(11/51),respectively.There were significantly differences between the two groups(χ^2 values:5.495,and 4.115,respectively;Pvalues:0.019 and 0.043,respectively).Conclusion The CT features of children with DR-TB are as follows:compared with children with DS-TB in the same age group,lung lesions are more widely distributed in children with DR-TB;multiple nodular lesions are common in DR-TB children aged 0-years old,and there is high incidence of bronchostenosis in DR-TB children aged 5-14 years old.
作者
宋敏
方伟军
韩远远
冯惠勇
SONG Min;FANG Wei-jun;HAN Yuan-yuan;FENG Hui-yong(Department of Radiology,Guangzhou Chest Hospital,Guangzhou 510095,China)
出处
《结核病与肺部健康杂志》
2020年第1期58-63,共6页
Journal of Tuberculosis and Lung Health
基金
广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]1555号)
广东省转化医学创新平台培育建设项目B类(惠卫函[2018]1254号)。
关键词
儿童
结核
肺
结核
抗多种药物性
体层摄影术
螺旋计算机
年龄组
疾病特征
数据说明
统计
Child
Tuberculosis,pulmonary
Tuberculosis,multidrug-resistant
Tomography,spiral computed
Age groups
Disease attributes
Data interpretation,statistical
