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分子诊断检测与胸部 X 射线联合多层螺旋 CT 在肺叶性肺炎诊断中的比较。

Comparison between the molecular diagnostic test and chest X-ray combined with multi-slice spiral CT in the diagnosis of lobar pneumonia.

机构信息

Department of Radiology, Image Center, Dongying Shengli Hospital of Shan Dong Province, Dongying City, Shan Dong Province, China.

出版信息

Cell Mol Biol (Noisy-le-grand). 2021 Nov 25;67(3):129-132. doi: 10.14715/cmb/2021.67.3.18.

Abstract

Lobar pneumonia is an inflammatory condition of the lung that mainly affects the lobes of the lungs and the alveoli, and it is usually caused by a bacterial infection. There are many ways to diagnosis this disease. But an early and accurate method for lobar pneumonia diagnosis has an important role in its treatment. Therefore, in this study, a comparison between the molecular diagnostic test and chest x-ray combined with multi-slice spiral CT was done to find out better diagnosis of lobar pneumonia. For this purpose, 122 individuals suspected of lobar pneumonia were studied by clinical examination, chest X-ray, and multi-slice spiral CT. For the molecular diagnosis test, the multiplex PCR was used for two main causes of the disease, Streptococcus pneumoniae and Klebsiella pneumoniae. Results showed that the specificity for Chest X-ray + Multi-slice Spiral CT had the highest amount (82.8%), but high sensitivity (100%) belonged to a molecular diagnostic test for both bacteria. On the other hand, the sensitivity and specificity of Streptococcus pneumoniae were better than Klebsiella pneumoniae and the possibility of error in Streptococcus pneumoniae was lower than Klebsiella pneumoniae. In general, although the Chest X-ray + Multi-slice Spiral CT method was better than the molecular diagnosis test, it could not identify the causative agent and did not show a difference between pathogens for better antibiotic treatment, and also the possibility of diagnosis is low at the beginning of the disease. Therefore, according to the results of the current study, the best way to diagnose lobar pneumonia is to use both methods, simultaneously.

摘要

大叶性肺炎是一种肺部炎症,主要影响肺叶和肺泡,通常由细菌感染引起。有许多方法可以诊断这种疾病。但是,大叶性肺炎的早期和准确诊断方法对其治疗具有重要作用。因此,在这项研究中,将分子诊断测试与胸部 X 射线和多层螺旋 CT 相结合,以寻找更好的大叶性肺炎诊断方法。为此,通过临床检查、胸部 X 射线和多层螺旋 CT 对 122 名疑似大叶性肺炎的个体进行了研究。对于分子诊断测试,使用多重 PCR 检测两种主要病原体,肺炎链球菌和肺炎克雷伯菌。结果表明,胸部 X 射线+多层螺旋 CT 的特异性最高(82.8%),但两种细菌的分子诊断测试的敏感性最高(100%)。另一方面,肺炎链球菌的敏感性和特异性均优于肺炎克雷伯菌,且肺炎链球菌的误诊可能性低于肺炎克雷伯菌。总体而言,尽管胸部 X 射线+多层螺旋 CT 方法优于分子诊断测试,但它无法识别病原体,也无法在更好地进行抗生素治疗方面显示出病原体之间的差异,而且在疾病初期的诊断可能性也较低。因此,根据当前研究的结果,诊断大叶性肺炎的最佳方法是同时使用这两种方法。

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