Wang Tao, Yang Qianwen, Gao Yan, Zhang Rongping, Zhou Chaoxin, Kong Weifang, Zhang Guojin, Chen Xinyue, Pu Hong, Shang Lan
Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
Department of Radiology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, Sichuan, People's Republic of China.
Int J Gen Med. 2023 Nov 6;16:5109-5118. doi: 10.2147/IJGM.S428962. eCollection 2023.
This study aimed to investigate clinical features and computed tomography (CT) manifestations of rifampicin primary drug-resistant pulmonary tuberculosis in Liangshan Yi Autonomous Prefecture.
A total of 100 inpatients with confirmed primary rifampicin-resistant pulmonary tuberculosis were recruited from January 2020 to December 2022 at an infectious disease hospital located in the Liangshan Yi Autonomous Prefecture. Additionally, 100 inpatients with confirmed drug-susceptible pulmonary tuberculosis during the same period were matched to the rifampicin-resistant group based on gender, age, and ethnicity. The clinical characteristics of the two groups were recorded separately. Furthermore, the CT manifestations in these patients were independently analyzed by three radiologists.
The results showed that comorbid diabetes mellitus was more prevalent in the drug-resistant tuberculosis (DR-TB) group than in the drug-susceptible tuberculosis (DS-TB) group (9% vs 0%, p=0.0032). In terms of imaging presentation, DR-TB patients exhibited a higher frequency of calcifications (55% vs 35.00%, p=0.0068), greater median number of cavities (5 vs 2, p=0.0027), and larger maximum cavity diameter (52.08±25.55 mm vs 42.72±17.48 mm, p=0.0097). Additionally, bilateral involvement was more common in DR-TB patients at the site of the lesion (89% vs 76%, p=0.0246), with a higher prevalence in the right middle (82% vs 68%, p=0.0332), right lower (82% vs 68%, p=0.0332), left upper (91% vs 77%, p=0.0113), and left lower lobes (92% vs 66%, p<0.0001). Conversely, the involvement of only one lobe was less frequent in patients with DR-TB than in those with DS-TB (4% vs 13%, p=0.0398), whereas the involvement of all five lobes was more common (68% vs 51%, p=0.0209).
Patients with DR-TB exhibit a higher prevalence of severe imaging manifestations, highlighting the importance of CT in the early detection and diagnosis of DR-TB.
本研究旨在探讨凉山彝族自治州利福平原发性耐药肺结核的临床特征及计算机断层扫描（CT）表现。
2020年1月至2022年12月期间，从凉山彝族自治州一家传染病医院招募了100例确诊为原发性利福平耐药肺结核的住院患者。此外，同期选取100例确诊为药物敏感肺结核的住院患者，根据性别、年龄和民族与利福平耐药组进行匹配。分别记录两组的临床特征。此外，由三位放射科医生独立分析这些患者的CT表现。
结果显示，耐药结核病（DR-TB）组合并糖尿病的情况比药物敏感结核病（DS-TB）组更为普遍（9%对0%，p=0.0032）。在影像学表现方面，DR-TB患者钙化频率更高（55%对35.00%，p=0.0068），空洞中位数更多（5个对2个，p=0.0027），最大空洞直径更大（52.08±25.55毫米对42.72±17.48毫米，p=0.0097）。此外，DR-TB患者病变部位双侧受累更为常见（89%对76%，p=0.0246），在右中叶（82%对68%，p=0.0332）、右下叶（82%对68%，p=0.0332）、左上叶（91%对77%，p=0.0113）和左下叶（92%对66%，p<0.0001）的患病率更高。相反，DR-TB患者仅一个叶受累的频率低于DS-TB患者（4%对13%，p=0.0398），而五个叶均受累更为常见（68%对51%，p=0.0209）。
DR-TB患者严重影像学表现的患病率更高，突出了CT在DR-TB早期检测和诊断中的重要性。
