关键词: 结核, 肺, 结核, 抗多种药物性, 临床对照试验, 体层摄影术, X线计算机, 回顾性研究

Abstract:

Objective To evaluate the characteristics of lung CT image in patients with cured multidrug-resistant pulmonary tuberculosis (MDR-PTB). Methods Forty-two patients who were diagnosed with MDR-TB from March 2012 to March 2018 in the Third People’s Hospital of Shenzhen and cured and no relapse occurred in two years were enrolled. Eighteen patients were divided into newly treated group and 24 patients were retreated groups. Consecutive lung CT images of 42 cured MDR-PTB patients were retrieved. The dynamic CT sign change at the time point of cure, 12 and 24 months after cure were analyzed. Results Respectively, 57.1% (24/42), 42.9% (18/42), and 31.0% (13/42) patients had active signs of PTB at the time point of cure, 12 months after cure, and 24 months after cure. Stable signs were observed in 69.0% (29/42), 81.0% (34/42), and 83.3% (35/42) patients at these time points. Uncertain signs were found in 40.5% (17/42) patients. At the time of cure, active signs were observed in 33.3% (6/18) newly treated group, and 75.0% (18/24) retreated group, and stable signs in 50.0% (9/18) newly treated and 83.3% (20/24) in retreated. The differences between two groups were statistically significant (χ ²=7.292, P=0.007; χ ²=5.347, P=0.021). At 12 months after cure, active signs were observed in 27.8% (5/18) newly treated, and 54.2% (13/24) in retreated, and stable signs in 83.3% (15/18) newly treated and in 79.2% (19/24) retreated. The differences between two groups were not statistically significant (χ ²=2.925, P=0.087; χ ²=0.116, P=1.000). At 24 months after cure, active signs were found in 22.2% (4/18) newly treated, and 37.5% (9/24) retreated, and stable signs in 88.9% (16/18) newly treated, and 79.2% (19/24) in retreated, and no statistical differences were found (χ ²=1.123, P=0.289; χ ²=0.700, P=0.679). At these different time points, uncertain signs were observed in 16.7% (3/18) newly treated, and 58.3% (14/24) retreated, and there was a statistical significance between the two groups (χ ²=7.412, P=0.006; χ ²=7.412, P=0.006; χ ²=7.412, P=0.006). Conclusion CT images showed signs of delayed repairment of pulmonary damage in most MDR-PTB patients after cure. Retreated MDR-PTB patients had more uncertain signs than newly treated MDR-PTB patients.

Key words: Tuberculosis, pulmonary, Tuberculosis, multidrug-resistant, Controlled clinical trial, Tomography, X-ray computed, Retrospective studies