非结核分枝杆菌肺病并发与未并发糖尿病患者的CT征象研究

目的探讨非结核分枝杆菌肺病并发与未并发糖尿病患者CT征象的差异,以期提高对两种疾病的鉴别诊断水平。方法收集2018年1—12月广州市胸科医院收治的经临床与实验室确诊为非结核分枝杆菌肺病并发糖尿病患者59例(A组)和非结核分枝杆菌肺病未并发糖尿病患者59例(B组)的CT检查资料,比较两组患者CT扫描显示的病灶分布及征象。采用SPSS 21.0软件进行统计学分析。计数资料采用χ²检验或连续校正χ²检验进行比较,均以P<0.05为差异有统计学意义。结果(1)病灶分布:A组病灶分布≥3叶的显示率(83.05%,49/59)明显高于B组(66.10%,39/59),差异有统计学意义(χ²=4.470,P=0.035)。(2)CT扫描征象:B组结节状病灶、树芽征的显示率分别为88.14%(52/59)、71.19%(42/59),均明显高于A组[分别为67.80%(40/59)、52.54%(31/59)],差异均有统计学意义(χ²值分别为7.104、4.346,P值分别为0.008、0.037);A组实...

Study on CT manifestations of non-tuberculous mycobacterium pulmonary disease patients with and without diabetes mellitus

Objective To explore the difference of CT manifestations between non-tuberculosis mycobacterium (NTM) lung disease patients with diabetes mellitus (DM) and those without DM,in order to improve the differential diagnosis of these two diseases. Methods A retrospective analysis of CT findings of 59 patients with NTM lung disease with DM (group A) and 59 patients with NTM lung disease without DM (group B) who were confirmed by clinical and laboratory tests in Guangzhou Chest Hospital from January to December 2018. The distribution of lesions and CT findings were compared between these two groups.SPSS 21.0 software was used for statistical analysis. χ² test or continuous correction χ² test were used for categorical data, statistical significance was set at P<0.05. Results (1) Lesion distribution: The incidence of lesions located in ≥3 lobes in group A (83.05%, 49/59) was higher than that in group B (66.10%, 39/59), the difference was statistically significant (χ²=4.470, P=0.035). (2) CT manifestations:The incidence of nodule and tree bud sign in group B were 88.14% (52/59) and 71.19% (42/59) respectively,higher than those in group A (67.80% (40/59), 52.54% (31/59)),differences were statistically significant (χ²=7.104, 4.346; P=0.008, 0.037).The incidence of solid shadow, cavity shadow, globular/lumpy shadow and honeycombing shadow in group A were 35.59% (21/59), 67.80% (40/59), 38.98% (23/59) and 25.42% (15/59) respectively, which were higher than those in group B (13.56%(8/59),49.15%(29/59),11.86%(7/59),3.39%(2/59)),differences were statistically significant (χ²=7.726,4.223,8.139,11.614;P=0.005,0.040,0.004,0.001).(3) Cavity lesions: The incidence of thick walled cavity in group A (55.93%, 33/59) was higher than that in group B (20.34%, 12/59), the incidence of thin walled cavity in group B (38.98%, 23/59) was higher than that in group A (22.03%, 13/59),these differences were both statistically significant (χ²=15.841, 3.997; P=0.000, 0.046). Cavities located in ≥3 lobes or the number of cavities ≥3 in group A accounted for 59.32% (35/59) and 57.63% (34/59) respectively, which were significantly higher than those in group B (28.81% (17/59) and 35.59% (21/59)), differences were statistically significant (χ²=11.140, 5.755; P=0.001,0.016). Conclusion Chest CT scan for patients with NTM lung disease with DM is more likely to show lesions with wide distribution, solid shadows, thick walled cavities, globular/lumpy shadows and honeycombing shadows;thin walled cavity, nodule and tree bud sign are more likely to be seen in patients without DM.Those CT manifestations are helpful for differential diagnosis.