Cheng Qian, Tang Yishu, Liu Jing, Liu FeiYang, Li Xin
Department of Hematology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Department of Emergency, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Infect Drug Resist. 2024 Oct 21;17:4557-4566. doi: 10.2147/IDR.S474229. eCollection 2024.
The role of chest computed tomography (CT) in distinguishing the causative pathogens of pulmonary infections in patients with hematological malignancies (HM) is unclear. The aim of our study was to compare and assess the clinical characteristics, radiologic features and potential differential diagnostic value of CT in HM patients and other different immune statuses patients with pulmonary infections.
Patients were divided into immunocompetent (105 cases) and immunocompromised groups (99 cases) according to immune status. Immunocompromised patients included the HM group (63 cases) and the non-HM group (42 cases). The basic clinical data and CT findings were collected and statistically analyzed.
Regarding the pathogen distribution, viral, and mixed infections were more common in the immunocompromised group than the immunocompetent (p < 0.01), but viral infections were more common in the HM group than in the non-HM group (p=0.013). Immunocompromised patients had more diverse CT findings and more serious lesions (mostly graded 2-4) than immunocompetent patients. The most common CT findings in HM patients were consolidation and ground-glass opacities (GGO), which were also found in the non-HM group. The overall diagnostic accuracy of CT was lower in immunocompromised patients than in immunocompetent patients (25.7% vs 50.5%, p< 0.01). CT had better diagnostic efficacy for fungi and in HM patients.
CT diagnosis is less efficient in distinguishing the causative pathogens of HM patients. However, CT can help distinguish fungal pneumonia and pneumonia in HM patients.
Our study might facilitate clinical decision-making in fungal pneumonia and pneumonia in HM patients.
胸部计算机断层扫描（CT）在鉴别血液系统恶性肿瘤（HM）患者肺部感染致病病原体方面的作用尚不清楚。我们研究的目的是比较和评估CT在HM患者及其他不同免疫状态的肺部感染患者中的临床特征、放射学特征及潜在的鉴别诊断价值。
根据免疫状态将患者分为免疫功能正常组（105例）和免疫功能低下组（99例）。免疫功能低下患者包括HM组（63例）和非HM组（42例）。收集基本临床数据和CT表现并进行统计分析。
在病原体分布方面，免疫功能低下组的病毒及混合感染比免疫功能正常组更常见（p<0.01），但HM组的病毒感染比非HM组更常见（p=0.013）。免疫功能低下患者比免疫功能正常患者有更多样化的CT表现和更严重的病变（大多为2-4级）。HM患者最常见的CT表现是实变和磨玻璃影（GGO），非HM组也有这些表现。免疫功能低下患者中CT的总体诊断准确性低于免疫功能正常患者（25.7%对50.5%，p<0.01）。CT对HM患者的真菌及[此处原文缺失部分内容]肺炎诊断效能更好。
CT诊断在鉴别HM患者致病病原体方面效率较低。然而，CT有助于鉴别HM患者的真菌性肺炎和[此处原文缺失部分内容]肺炎。
我们的研究可能有助于HM患者真菌性肺炎和[此处原文缺失部分内容]肺炎的临床决策。
