关键词: 结核, 肺, X线计算机, 体层摄影术, 利福平, 抗药性, 细菌

Abstract: Objective To comparatively analyze the CT findings in patients with initial and retreated cavernous rifampicin-resistant tuberculosis. Methods From January 2020 to January 2021, 72 cavernous rifampicin-resistant tuberculosis patients confirmed by drug sensitivity test at Tuberculosis Hospital of Shannxi Province were collected and divided into initial treatment group (n=34) and retreatment group (n=38) according to the treatment history. Differences in the general clinical data, cavernous and non-cavernous CT findings between two groups were analyzed. Besides, CT findings in two groups, including cavity number, maximum inner diameter of cavity, cavity wall calcification, lung consolidation, destructive lung, emphysema and intrapulmonary calcification were comparatively analyzed. Results As revealed by comparisons of cavity lesion CT findings between two groups, the median cavity number in retreatment group was 5.0 (2.0, 10.0), while that in initial treatment group was 2.0 (1.0, 5.0), and the difference was of statistical significance (Z=2.020, P<0.05). The maximum inner diameter of cavity in retreatment group was 19.40 (13.09,34.09) mm, while that in initial treatment group was 12.31 (5.35,22.97) mm, and the difference was of statistical significance (Z=2.662, P<0.05). The rate of cavity wall calcification in retreatment group was 42.11% (16/38), while that in initial treatment group was 17.65% (6/34), and the difference was statistically significant (χ ²=5.059, P<0.05). When comparing the CT signs of non-cavity lesions between two groups, the rates of lung consolidation, destroyed lungs, emphysema and intrapulmonary calcification in retreatment group were 78.95% (30/38), 39.47% (15/38), 39.47% (15/38), 52.63% (20/38), respectively; while those in initial treatment group were 52.94% (18/34), 17.65% (6/34), 14.71% (5/34), 23.53% (8/34), separately, and the differences were of statistical significance (χ ² values were 5.461, 4.138, 5.487 and 6.395, respectively; allP<0.05). Conclusion Compared with initial treatment patients, retreated cavernous rifampicin-resistant tuberculosis patients had more cavities, greater maximum inner diameter of cavity, along with more severe CT findings of cavity wall calcification, lung consolidation, destroyed lungs, emphysema and intrapulmonary calcification.

Key words: Tuberculosis, pulmonary, X-ray computed, tomography, Rifampicin, Drug resistance, bacterium