初治与复治耐多药肺结核患者的临床特征及胸部CT征象分析OA
Analysis on Clinical Characteristics and Chest CT Signs in Newly Treated and Retreated Patients with Multidrug-Resistant Pulmonary Tuberculosis
目的 分析初治与复治耐多药肺结核患者的临床特征及胸部CT征象差异.方法 回顾性纳入 2024 年 3 月至 2025 年3 月期间在我院经药敏试验确诊的 98 例耐多药肺结核患者,其中初治患者 43 例,设为初治组;复治患者 55 例,设为复治组.收集两组患者的基线资料、临床特征、胸部CT影像资料并进行对比,采用Logistic回归分析复治耐多药肺结核的独立影响因素.结果 两组患者的年龄、体质量指数、性别、吸烟史、饮酒史、主诉症状及合并症比较,差异均无统计学意义(均P＞0.05).在胸部CT征象方面,两组的患侧、树芽征、腺泡结节、斑片状影、大片状影及胸腔积液检出率比较,差异均无统计学意义(均P＞0.05);复治组表现为病灶多叶受累、空洞、条索状影、钙化灶、胸膜增厚、支气管扩张的患者比例及CT评分均高于初治组(P＜0.05).多因素Logistic回归分析显示,胸部CT显示空洞(OR=2.143,95%CI:1.336～3.436)、钙化灶(OR=2.125,95%CI:1.320～3.422)、胸膜增厚(OR=1.984,95%CI:1.227～3.207)是复治耐多药肺结核的独立影响因素(P＜0.05).结论 初治与复治耐多药肺结核患者的胸部CT征象存在显著差异,复治耐多药肺结核患者以病变多叶受累、条索状影、钙化灶、空洞、胸膜增厚及支气管扩张等征象为主,其中钙化灶、空洞、胸膜增厚是复治耐多药肺结核的独立影响因素.
Objective To analyze the differences in clinical characteristics and chest CT signs between newly treated and retreated patients with multidrug-resistant pulmonary tuberculosis.Methods A retrospective analysis was conducted on 98 patients with multidrug-resistant pulmonary tuberculosis confirmed by drug susceptibility testing in our hospital from March 2024 to March 2025.Among them,43 newly treated patients were assigned to the newly treated group and 55 retreated patients to the retreatment group.The baseline data,clinical characteristics,and chest CT imaging data of the two groups were collected and compared.Logistic regression analysis was used to identify the independent influencing factors of retreated multidrug-resistant pulmonary tuberculosis.Results There were no statistically significant differences between the two groups in age,body mass index,sex,smoking history,alcohol consumption history,chief complaints and comorbidities(all P>0.05).Regarding chest CT signs,the detection rates of the affected side,tree-in-bud sign,acinar nodules,patchy shadows,large patchy shadows,and pleural effusion showed no statistically significant differences between the two groups(all P>0.05).The proportions of patients with multi-lobe involvement,cavities,fibrous cords,calcification,pleural thickening,and bronchiectasis,as well as the CT scores,in the retreatment group were significantly higher than those in the newly treated group(P<0.05).Multivariate Logistic regression analysis revealed that chest CT-confirmed cavities(OR=2.143,95%CI:1.336～3.436),calcification(OR=2.125,95%CI:1.320～3.422),and pleural thickening(OR=1.984,95%CI:1.227～3.207)were independent influencing factors for retreated multidrug-resistant pulmonary tuberculosis(P<0.05).Conclusions Significant differences exist in chest CT signs between newly treated and retreated patients with multidrug-resistant pulmonary tuberculosis.Retreated patients with multidrug-resistant pulmonary tuberculosis predominantly present with multi-lobe involvement,fibrous cords,calcification,cavities,pleural thickening,and bronchiectasis.Among these,calcification,cavities,and pleural thickening are independent influencing factors for retreated multidrug-resistant pulmonary tuberculosis.
王陈晋;李小平
兰州市肺科医院 综合内科,甘肃 兰州 730000兰州市肺科医院 呼吸科,甘肃 兰州 730000
医药卫生
耐多药肺结核初治患者复治患者临床特征胸部CT征象
Multidrug-resistant pulmonary tuberculosisNewly treated patientRetreated patientClinical characteristicChest CT sign
《临床医学工程》 2026 (8)
960-964,5
兰州市科技计划项目(项目编号:2023-ZD-153)
评论