不同影像学特征对煤工尘肺患者院内获得性支气管-肺感染辅助检查的影响

目的了解煤工尘肺（CWP）不同影像学特征对院内获得性支气管-肺感染（HAPI）各项辅助检查的影响。方法采用回顾性的研究方法,观察HAPI在不同小阴影类型及尘肺期别中各项辅助检查的分布特点。结果CWP患者发生HAPI时,血常规中白细胞总数及中性粒细胞比例均正常的发生率,在类圆形小阴影与不规则小阴影CWP间：Ⅰ期CWP中均出现类圆形小阴影的发生率大于不规则小阴影,分别P〈0.01,P〈0.05;在Ⅰ期CWP中还发现,p、q、s小阴影类型的发生率大于t阴影,分别P〈0.05,P〈0.01,P〈0.05;在不同期别CWP间、不规则小阴影及t阴影中,分别观察到Ⅱ期的发生率大于Ⅲ期,且在t阴影中还观察到Ⅱ期发生率大于Ⅰ期,均P〈0.05。血常规中仅中性粒细胞比例增高的发生率,在CWP期别间：类圆形小阴影CWP中、q阴影中,随着尘肺期别的升高而升高,分别P〈0.01,P〈0.01,P〈0.05;在Ⅰ期CWP中t阴影的发生率分别大于p、q阴影,P〈0.05。血常规中白细胞总数及中性粒细胞比例均增高的发生率,Ⅱ期CWP的发生率均小于Ⅰ期、Ⅲ期CWP,P〈0.05;在类圆形小阴影、p阴影中均观察到,Ⅱ期CWP的发生率小于Ⅰ期CWP,分别P〈0.05,P〈0.01;Ⅰ期CWP中q阴影的发生率小于P阴影,P〈0.01。血常规中仅白细胞总数增高的发生率,在不同影像学特征CWP患者中的分布,没有发现差别,P〉0.05。X线胸片报告“慢性炎症”、痰培养致病菌检出率在类圆形小阴影、不规则小阴影间分布没有差别,均P〉0.05。结论总的来看,CWP患者HAPI时,尘肺期别及纤维化程度越高,范围越广,对白细胞总数及中性粒细胞比例的影响越大,同时,我们应该注意到差异;没有观察到不同影像学特征CWP对X线胸片“慢性炎症”、痰培养中致病菌分布的明显差异。

Effect of Different Image Features on the Auxiliary Examination of HAPI of the CWP Patients

Objective]To learn the effect of different image features on the auxiliary examination of HAPI of the CWP patients. Methods] Retrospective method was applied to observe the different shadow types and distribution features of various auxiliary examinations in the CWP period. Results] When the CWP patients had HAPI, the incidence rate of normal leukocyte counting and litmusless granule cells was between the round small shadow and irregular small shadow: in stage I of CWP, the incidence rate of round small shadow (P<0.01) was higher than that of the irregular small shadow (P<0.05); the incidence rate of p, q and s small shadow (P<0.05) was higher than that of the t shadow (P<0.01); the incidence rate of irregular small shadow and t shadow in stage II was higher than that in stage III, while the incidence rate of t shadow in stage II was higher than that in stage I (P<0.05). The distribution of chronic inflammation and the detection rate of sputum cultured pathogen in the round small shadow and the irregular small shadow showed no difference (P>0.05). Conclusion] Generally speaking, when CWP patients have HAPI, the higher the stage of pneumoconiosis and the fibrosis level are, the greater effect it has on the leukocyte counting and litmusless granule cells; no significant difference was observed in the distribution of chronic inflammation and sputum cultured pathogen in different image features.