不同年龄组继发性肺结核空洞与肺内其他病变的CT评价

目的探讨年龄因素对继发性肺结核空洞与肺内其他结核性病变CT表现的影响。方法 98例肺结核空洞伴肺内其他结核性病变患者按其不同年龄段分为3组：17-35岁为第1组（42例）,36-60岁为第2组（34例）,60岁以上为第3组（22例）。所有患者均经抗结核治疗,其中,65例又经胸部CT复查。对3组间肺结核空洞与肺内其他结核性病变的CT表现,采用卡方检验和SPSS13.0统计软件进行了对比分析,以P〈0.05为有统计学意义。结果 CT显示98例中有138个结核性空洞,其中,单发63例,多发35例。3组间在空洞数目、空洞与胸膜的关系、空洞内壁规则与否方面比较有显著性差异（P〈0.001）。3组在结核活动性病变诸如树芽征、磨玻璃样密度影、小叶斑片状实变影、肺叶实变影、结核结节或结核瘤、胸腔积液方面比较有差异（P〈0.05）;在结核非活动性病变诸如肺大泡、胸膜肥厚比较有差异（P〈0.05）。3组经抗结核治疗后CT复查在空洞大小,肺内病变,胸膜肥厚方面比较有差异（P〈0.05）。结论随年龄段增加,继发性肺结核空洞主要以大空洞及厚壁空洞为主,并向胸膜下扩展,周围肺组织纤维化加重,肺内其他结核性病变以融合结节多见。

CT evaluation of secondary pulmonary tuberculous cavities and other intrapulmonary tuberculous lesions in different age patients

Objective To discuss the effect of age factor on CT findings of secondary pulmonary tuberculous cavities（SPTCs） and other intrapulmonary tuberculous lesions（IPTLs）.Methods Ninety-eight patients with SPTCs and IPTLs based on their ages were divided into following three groups： aged 17-35 years were classified into group 1（n=42）,36-60 years into group 2（n=34）,and over 60 years into group 3（n=22）.All patients underwent antituberculous therapy,of whom,65 patients underwent additional CT reexaminations of the chest.CT findings between three groups were comparatively analyzed by using Chi-square test and statistic software SPSS 13.0 and P value less than 0.05 was considered significantly different.Results CT showed that there were total 138 tuberculous cavities in 98 patients who comprised 63 single and 35 multiple.The comparison between three groups in the numbers of cavities,the relationship between cavitics and pleurae,and cavitary inner walls to be whether or not smoth and regular seen on CT images was significant difference（P 0.001）.The comparison between three groups in active tuberculous lesions such as tree-bud signs,ground-glass density shadows,lobular patchy consolidation shadows,lung lobe consolidation shadows,tuberculous nodules or tuberculomas,and pleural effusion was statistic difference（P 0.05）;the comparison between three groups in inactive tuberculous lesions such as lung bullae and pleural thickening was statistic difference（P 0.05）.Following antituberculous therapy,the comparison between three groups in cavitary size,intrapulmonary lesions and pleura thickening was statistic difference（P 0.05）.Conclusion With age increasing,secondary pulmonary tuberculous cavities most are big cavities,thick walled cavities and extend to under-pleura,lung tissues around the cavities are increased fibrosis,while other intrapulmonary tuberculous lesions are predominanted by consolidated nodes.