Analysis of CT characteristics of multi-drug resistant pulmonary tuberculosis complicated with diabetic mellitus

doi:10.3969/j.issn.1000-6621.2019.07.012

Abstract

Abstract:

Objective To compare the CT findings of pulmonary multi-drug-resistant tuberculosis with or without diabetic. Methods Data of 660 pulmonary multi-drug-resistant tuberculosis patients were collected. All the patients were from Beijing Chest Hospital affiliated to Capital Medical University between 2012 and 2017 and diagnosed on sputum-positive and results of drug sensitivity test. They were divided into diabetic group (n=159) and non-diabetic group (n=501). A total of 120 patients were randomly selected from the two groups (each n=60), and the signs and distribution in CT images of them were re-diagnosed by two radiologists without information of complications. Data were ananlyzed using SPSS 17.0 software by chi-square test or Fisher exact test. Quantitative data were analyzed by Mann-Whitney U test. P<0.05 was considered statistically significant. Results The segmental or lobar consolidation, large nodules, cavities and pleural effusion in diabetic group were significantly higher than those in non-daibetic group (48.3% (29/60) vs. 28.3% (17/60), χ ²=5.08, P=0.024; 26.7% (16/60) vs. 11.7% (7/60), χ ²=4.36, P=0.037; 93.3% (56/60) vs. 76.7% (46/60), χ ²=6.54, P=0.011; 40.0% (24/60) vs. 20.0% (12/60), χ ²=5.71, P=0.017), so were the number of lobes involved by segmental or lobar consolidation, large nodules and the number of lobes involved by any form of cavities (0.78±0.96 vs. 0.38±0.72, U=1380.50, P=0.011; 0.48±0.96 vs. 0.13±0.39, U=1511.00, P=0.027; 2.05±1.43 vs. 1.58±1.43, U=1432.00, P=0.046); while bronchiectasis in diabetic group was significantly lower than that in non-daibetic group (45.0% (27/60) vs. 70.0% (42/60), χ ²=7.67, P=0.006; 0.97±1.37 vs. 1.58±1.57, U=1335.50, P=0.010). Conclusion The frequency and range of segment or lager consolidation segmental or lobar consolidation, large nodules and cavity, as well as pleural effusion, are higher in patients of pulmonary multi-drug-resistant tuberculosis complicated with diabetic, while the bronchiectasis is more frequent in patients without diabetes mellitus.

Key words: Tuberculosis,pulmonary, Tuberculosis,multidrug-resistant, Diabetes mellitus, Comorbidity, Tomography,X-ray computed, Disease attributes

Duo LI,Fu-zhi ZHANG,Bao-xia CAO,Dai-lun HOU,Ping-xin LYU. Analysis of CT characteristics of multi-drug resistant pulmonary tuberculosis complicated with diabetic mellitus[J]. Chinese Journal of Antituberculosis, 2019, 41(7): 765-769. doi: 10.3969/j.issn.1000-6621.2019.07.012

Figures/Tables 2

CT征象	累及肺叶数( $x ˉ$ ±s,个)		U值	P值
CT征象	并发组(60例)	未并发组(60例)	U值	P值
总累及叶数	4.72±1.47	4.30±1.74	1572.00	0.212
小叶或亚段实变	2.60±1.60	2.08±1.64	1438.00	0.053
段或叶性实变	0.78±0.96	0.38±0.72	1380.50	0.011
大结节	0.48±0.96	0.13±0.39	1511.00	0.027
树芽征	3.85±1.64	3.52±1.73	1642.50	0.401
任何形式空洞	2.05±1.43	1.58±1.43	1432.00	0.046
实变内空洞	0.98±1.27	0.73±1.15	1576.00	0.196
结节空洞	1.28±1.30	1.00±1.12	1579.50	0.224
支气管扩张	0.97±1.37	1.58±1.57	1335.50	0.010
钙化	0.43±1.16	0.55±1.03	1576.00	0.121
肺叶体积缩小	0.35±0.68	0.25±0.65	1635.00	0.241

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CT征象	并发组(60例)	未并发组(60例)	χ²值	P值
小叶或亚段实变	56(93.3)	52(86.7)	1.48	0.224
段或叶性实变	29(48.3)	17(28.3)	5.08	0.024
大结节	16(26.7)	7(11.7)	4.36	0.037
树芽征	59(98.3)	57(95.0)	-	0.619^a
任何形式空洞	56(93.3)	46(76.7)	6.54	0.011
实变内空洞	31(51.7)	24(40.0)	1.65	0.200
空洞结节	42(70.0)	34(56.7)	2.30	0.130
支气管扩张	27(45.0)	42(70.0)	7.67	0.006
钙化	11(18.3)	19(31.7)	2.84	0.092
肺叶体积缩小	15(25.0)	9(15.0)	1.88	0.171
淋巴结肿大	17(28.3)	18(30.0)	0.04	0.841
胸腔积液	24(40.0)	12(20.0)	5.71	0.017