摘要
目的分析CT影像学技术在肺结核患者曲霉菌属感染中的诊断价值,提高临床诊断准确性。方法选择2014年8月-2016年9月医院收治的肺结核合并肺部感染患者300例为研究对象,对病原菌进行分析;对曲霉菌属感染患者进行病理学检查,并给予患者CT影像检查,依照病理学结果作为金标准,分析肺结核合并曲霉菌属感染患者CT特征及其临床诊断价值。结果 300例肺部感染患者共培养分离病原菌326株,其中革兰阴性菌166株占50.92%、革兰阳性菌25株占7.67%,真菌135株占41.41%,其中曲霉菌属感染患者48例;曲霉菌属感染患者CT诊断结果表明空洞、晕征、胸腔积液及多个肺叶受累等均可作为肺结核合并曲霉菌属感染的CT表现特征;与单纯肺结核患者比较,CT影像特征明显,合并感染患者的CT特异性更高;以病理学结果作为金标准,CT诊断准确率较高,灵敏性与特异性分别为92.33%、88.42%。结论肺结核患者曲霉菌属感染应用CT进行诊断与病理学检查结果较为一致,其在CT影像学中有明显的特征表现,可将空洞、晕征等表现作为临床CT诊断的可靠标准,具有一定的临床价值。
OBJECTIVE To study the value of CT imaging in the diagnosis of pulmonary tuberculosis complicated with Aspergillus infection,so as to improve the accuracy of clinical diagnosis.METHODS 300 cases of pulmonary tuberculosis patients with pulmonary infection enrolled in our hospital from Aug.2014 to Sep.2016 were included in this study,and analyzed for pathogens.Pathological examination and CT imaging were conducted for the patients infected with Aspergillus.Using the pathological results as the gold standard,the CT features of pulmonary tuberculosis patients with Aspergillus infection and the clinical diagnostic value were analyzed.RESULTS A total of 326 strains of pathogens were isolated from the 300 cases of pulmonary infection patients,of which 166 strains were gram-positive bacteria accounting for 50.92%,25 strains were gram-negative bacteria accounting for 7.67%,135 strains were fungi accounting for 41.41%,among which 48 cases were infected with Aspergillus.CT diagnosis of patients with Aspergillus infection showed that the findings of cavitation,halo sign,pleural effusion and involvement of multiple lung lobes can be used as CT features of patients with pulmonary tuberculosis and Aspergillus infection.Compared with patients with simple tuberculosis,the CT features were more obvious and the CT specifity was higher for those with co-infection.Using the pathological results as the gold standard,the diagnostic accuracy of CT was relatively high.The sensitivity and specificity were 92.33% and 88.42%,respectively.CONCLUSION The diagnosis of pulmonary tuberculosis with Aspergillus infection is consistent with the results of pathology,showing obvious characteristics in CT imaging,such as cavitation and halo sign,which can be used as a reliable standard for clinical CT diagnosis with high clinical application value.
作者
洪宗启
刘斌
裴仁明
杜北珏
刘文冬
HONG Zong-qi;LIU Bin;PEI Ren-ming;DU Bei-jue;LIU Wen-dong(The First Affiliated Hospital of Medical University of Anhui,Anhui,Hefei 230022,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第19期2928-2931,共4页
Chinese Journal of Nosocomiology
基金
安徽省自然科学基金资助项目(1208085MH146)
关键词
CT
肺结核
曲霉菌属
感染
CT
Pulmonary tuberculosis
Aspergillus
Infection
