探讨活动性肺结核HRCT7种征象对CT总评分的影响

目的探讨活动性肺结核HRcT7种征象对cT总评分的影响。方法回顾性分析，对548例曾行I{RcT检查的患者进行HRcT评分，每侧肺组织划分为三个区域，分别对各自类型cT征象所累及的范围进行HRCT评分；以HRCT总分为因变量（Y），大结节（X1）、微结节（X2）、实变（x3）、磨玻璃影（X4）、空洞（x5）、支气管损伤（x6）、间质损伤（X7）7种征象为自变量，采用多元逐步回归方程分析各类型CT征象对I{RCT总评分的影响程度。结果当把7种征象均纳入方程式时，复相关系数（R）=0．998、决定系数（R？）=0．996和P值〈0．001；多元逐步回归分析模型方程式为：Y=0．098＋1.009x1＋0．978X2＋0．975X3＋0．999X4＋0．989X5＋0．935x6＋1．043x7；各系数相对应标准化回归系数为：0．223、0．219、0．173、0．152、0．112、0．173和0．171。结论当把7种征象均纳入方程式时，R、R？和P值为最优状态；对HRCT总评分的影响（贡献）程度，赶结节为最大，微结节次之，空洞为最小。研究结果为指导临床肺结核的诊疗提供了帮助。

The Influence of Seven CT Signs in Patients with Active Pulmonary Tuberculosis on To- tal Scores of HRCT Finding

Objective TO investigate the influence of seven CT signs in patients with active pulmonary tuberculosis （PTB） on total scores of HRCT finding. Method 548 PTB pa- tients that have been scanned by HRCT were included into the study. Every lung field was divided into 3 zones. Extent to disease in each zone abnormalities was evaluated and summed to a HRCT score. We used total score as dependent variable（Y）, nodule（x 1）, micro-nodule（x2）, consolidation （x3）, ground-glass opacity（x4）, cavitations（x5）, bronchial lesion（x6） and mesenchyma bands（x7） as independent variable, then the data was analyzed by stepwise regression. Results All of seven CT signs were included into the equation. The multiple correlation coefficient （R）=0.998, the R square=0.996 and Probability〈0.001 The equation is Y=0.098＋1.009Xl＋0.978X2＋0.975X3＋0.999X4＋0.989X5＋0.935X6＋1. 043X7, and the Standardization regression coefficient is 0.223, 0.219, 0.173, 0.152, 0.112, 0.173 and 0.171. Conclusion Study indicated when all of seven CT signs were included into the equation, the R, R2 and Probability are optimal. Nodule was the most influence on total scores of HRCT findings, then micro-nodule, the least one is cavitations. The results have a critical role in guiding clinical diagnosis and therapeutic effect assessment of active PTB patients.