肺气肿合并结核临床和影像学特征分析

目的 探讨肺气肿合并结核临床和影像学特征,提高对不典型影像表现的识别能力.方法 搜集肺气肿合并结核患者97例为研究对象,按影像学特征分为实变组33例和非实变组64例.对两组临床表现、影像学特征及转归进行观察和比较.结果 在临床表现方面,发热、病原学阳性率、体重下降、耐R率、气肿严重程度分级、血浆白蛋白均值、N/L(比值...

Analysis of clinical and imaging features of emphysema complicated with tuberculosis

Objective To explore the clinical and imaging features of emphysema combined with tuberculosis,and to improve the ability to recognize atypical imaging manifestation.Methods 97 cases of emphysema complicated with tuberculosis were selected.According to the imaging characteristics,they were divided into 33 cases in the consolidation group and 64 cases in the non-consolidation group.The clinical manifestations,imaging characteristics and outcomes of the two groups were observed and compared.Results In terms of clinical manifestations,there were statistically significant differences in fever,positive rate of etiology,proportion of weight loss,R resistance rate,severity grading of emphysema,mean plasma albumin values,N/L(ratio),lymphocyte count(10⁹/L),C-reactive protein(mg/L),erythrocyte sedimentation rate(mm/1 h)between the two groups(P<0.01).In terms of imaging manifestations,the signs of the consolidation group were mainly consolidation,GGO,thickening of the air cavity wall,imitation moth-eaten cavity,cavities,and lack of imaging signs of typical tuberculosis.The signs of thenon-consolidation group were mainly nodules and tree bud signs.In terms of dynamic follow-up,the incidence of progression before treatment and within 1 to 2 months of treatment was 48.4%and 16.2%in the consolidation group and the non-consolidation group,respectively(P<0.01).The incidence of residual damage in the consolidation group and non-consolidation group was 51.5%and 21.6%,respectively(P<0.05).Conclusion Pulmonary consolidation mode is an important feature of emphysema with tuberculosis.Due to the tendency of rapid progression and caseous necrosis,it is recommended to improve tuberculosis-related examinations as soon as possible to reduce misdiagnosis and poor prognosis.