耐多药肺结核患者胸部影像学特点分析

目的探讨耐多药肺结核（MDR—PTB）患者的胸部影像学特点。方法选择86例MDR—PTB患者（观察组）和60例不耐药肺结核患者（对照组）作为研究对象，比较两组患者的病灶分布、病灶形态及病灶动态变化情况。结果观察组病灶累及≤2个肺叶的比例小于对照组，累及≥3个肺叶的比例及合并肺损毁的比例均大于对照组，差异均有统计学意义（P〈0．05）；观察组空洞及肺内播散发生率高于对照组（P〈0．05），两组肺实变、肺不张、胸腔积液、浸润性病灶的发生率差异无统计学意义（P〉0．05）；观察组病灶显著吸收率及空洞闭合率均低于对照组，而病变恶化率及空洞增大率均高于对照组，差异均有统计学意义（P〈0．05）。结论MDR—PTB是最为严重的一类结核病．影像学表现具有病变分布范围广，空洞、肺内播散灶及肺毁损发生率高等特点。

Chest-imaging analysis of patients with multidrug resistant pulmonary tuberculosis

Objective To investigate the chest-imaging characteristics of patients with multidrug resistant pulmonary tuberculosis（MDR-PTB）. Methods 86 patients with MDR-PTB（observation group） and 60 patients（control group） with drug-sensitive tuberculosis were chosen as the research objects,the lesions distribution,morphology and changes of dy- namic focal lesions of the patients between the two groups were compared. Results The ratio of the lesions involved in less than or equal to 2 lobes of the observation group were smaller than those of the control group,the ratio of the le- sions involved in more than or equal to 3 lobes and the ratio of pulmonary amage were greater than those of the control group,the differences were all statistically significant（P〈0.05）; The rates of cavities and the incidence of pulmonary dis- semination of the observation group were higher than those of the control group （P〈0.05）;compared with the incidence of pulmonary consolidation,atelectasis,pleural effusion,infiltrative lesions,there were no significant differences between the two groups （P〉0.05）;the significant absorption rate and the cavity closure rate of the observation group were lower than those of the control group,while the rate of deterioration of the lesions and the rate of cavity increasing were higher than those of the control group,the differences were all statistically significant （P〈0.05）. Conclusion MDR-PTB is the most serious kind of tuberculosis,the imaging manifestations has the characteristics of lesions of wide distribution,the high rate of cavity,pulmonary disseminated lesions and pulmonary damage etc.