药物敏感肺结核和多药/广泛耐药肺结核之间肺腔特征的差异:一项基于计算机断层扫描的多国多中心研究
Sheng-Nan Tang1, Xi-Ling Huang1,2,3, Alena Skrahina4
1Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Journal of thoracic disease
|March 12, 2026
概括
多耐药结核病 (MDR) 和广泛耐药结核病 (XDR) 患者的肺腔 (PC) 患病率高于药物敏感结核病 (DS) 患者. 这种差异与Mycobacterium结核病的攻击性有关,而不仅仅是疾病史.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 肺腔 (PC) 在多耐药 (MDR) 和广泛耐药 (XDR) 结核病患者中比药物敏感 (DS) 结核病患者更常见.
- 了解导致PC流行率差异的因素对于有效的结核病管理至关重要.
研究的目的:
- 调查Mycobacterium结核病的攻击性和患者病史如何影响DS与MDR/XDR结核病患者的肺腔患病率和模式.
- 为了区分PC特征在药物敏感和耐药结核病病例之间.
主要方法:
- 从244个DS,344个MDR和155个XDR结核病例 (新患者和以前接受过治疗的患者) 的胸部CT图像分析.
- 肺腔 (PC) 的量化,其光径>5毫米,并记录肺化.
- 与DS和MDR/XDR患者组之间的PC流行率,数量和直径的比较.
主要成果:
- 与DS患者相比,MDR/XDR患者表现出明显更高的PC流行率和更广泛的肺部参与.
- PC患病率随着耐药性增加,特别是在之前接受治疗的患者中 (DS: 36.4%,MDR: 57%,XDR: 71.4%).
- 一个PC数 ≥2显示高特异性诊断MDR/XDR在新患者 (92.3%) 和先前治疗的患者 (81.0%).
结论:
- 与DS患者相比,MDR/XDR患者的PC患病率更高,肺部参与程度更大,受疾病持续时间以外的因素的影响.
- 虽然PC数≥3表明MDR诊断,但敏感性是有限的.
- 肺腔的特征可以帮助区分耐药结核病和药物敏感结核病.
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