学术论文

      胸部CT早期诊断小儿支原体肺炎合并链球菌肺炎的价值

      The value of chest CT in the early diagnosis of mycoplasma pneumonia complicated with streptococcus pneumonia

      摘要:
      目的 评估胸部CT鉴别小儿支原体肺炎(MP)合并链球菌肺炎(SP)的临床价值.方法 选取肺炎患儿78例,其中肺炎支原体IgM阳性而肺炎链球菌血培养阴性患儿45例(对照组),肺炎支原体IgM和肺炎链球菌血培养阳性33例(观察组).比较两组胸部CT表现.结果 观察组磨玻璃影、支气管壁增厚、支气管血管束增厚和网状影发生率明显低于对照组[15.15%(5/33)比73.33%(33/45)、42.42%(14/33)比100.00%(45/45)、33.33%(11/33)比86.67%(39/45)和36.36%(12/33)比80.00%(36/45)],差异有统计学意义(P<0.01);两组支气管充气相发生率比较差异无统计学意义(P>0.05).观察组胸腔积液发生率、胸腔积液厚度和淋巴结横径明显高于对照组[42.42%(14/33)比15.56%(7/45)、(13.50±6.81)mm比(3.22±1.14)mm和(11.18±2.43)mm比(2.91±0.84)mm],差异有统计学意义(P<0.01或<0.05);两组淋巴结影发生率均为100.00%(33/33和45/45).观察组无规律肺内实变影发生率明显高于对照组[81.82%(27/33)比26.67%(12/45)],差异有统计学意义(P<0.01).结论 单纯MP和MP合并SP患儿的CT表现各有不同,胸部CT检查在鉴别诊断中有一定的价值.
      Abstract:
      Objective To investigate the value of chest CT in the early diagnosis of mycoplasma pneumonia (MP) complicated with streptococcus pneumonia (SP) in children. Methods Seventy- eight children with pneumonia were selected, among them pneumonia mycoplasma IgM positive but pneumonia streptococcus hemoculture negative was in 45 cases (control group), and pneumonia mycoplasma IgM and pneumonia streptococcus hemoculture positive was in 33 cases (observation group). The chest CT performance was compared between 2 groups. Results The incidences of ground- glass opacity, bronchial wall thickening, branch pipe bundle thickening and reticular shadow in observation group were significantly lower than those in control group: 15.15% (5/33) vs. 73.33% (33/45), 42.42% (14/33) vs. 100.00%(45/45), 33.33%(11/33) vs. 86.67%(39/45) and 36.36%(12/33) vs. 80.00%(36/45), and there were statistical differences (P<0.01); there was no statistical difference in the incidence of bronchial inflation phase between 2 groups (P>0.05). The pleural effusion incidences, pleural effusion thickness and lymph node transverse diameter in observation group were significantly higher than those in control group:42.42%(14/33) vs. 15.56%(7/45), (13.50 ± 6.81) mm vs. (3.22 ± 1.14) mm and (11.18 ± 2.43) mm vs. (2.91 ± 0.84) mm, and there were statistical differences (P<0.01 or<0.05). The incidences of lymph node shadow in 2 groups were 100.00% (33/33 and 45/45). The incidence of irregular pulmonary real change shadow in observation group was significantly higher than that in control group: 81.82%(27/33) vs. 26.67% (12/45), and there was statistical difference (P<0.01). Conclusions Simple MP and MP complicated with SP in children has different CT manifestations, and the chest CT examination has certain value in the differential diagnosis.
      作者: 高丽群
      Author: Gao Liqun
      作者单位: 122000,辽宁省朝阳市中心医院放射科
      刊 名: 中国医师进修杂志 ISTIC
      年,卷(期): 2017, 40(3)
      在线出版日期: 2017年3月31日