【摘要】 目的 本研究旨在深入剖析耐药肺结核患者与非耐药肺结核患者在胸部CT检查中所呈现的临床影像学特征，通过系统对比与分析，为临床上疑似耐药肺结核病例的诊断提供具有参考价值的影像学证据。方法 选取商丘市胸科医院2022年5月至2023年5月收治的68例肺结核患者，依据所收集的数据资料，将研究对象划分为两组，各34例，其中对照组为非耐药肺结核患者，研究组为耐药肺结核患者，比较两组患者的胸部CT影像学资料。结果 ⑴两组临床资料比较，治疗类型、间歇性用药史，经统计学分析有统计学意义(P<0.05)；⑵两组CT影像学资料比较，全肺累及(CT累及肺部位、肺叶数)、气道病变(肺气肿、肺不张、支气管扩张、支气管播散病灶)、肺内病灶(渗出性病变、增值性病变、钙化、空洞)、合并症(损毁肺、尘肺)中经统计学分析有统计学意义(P<0.05)；转归比较中，研究组患者与对照组患者的转归病例分别为18和26，无变化和进展方面，研究组明显高于对照组，但对照组转归例数优于研究组，经统计学分析有统计学意义(P<0.05)；⑶全肺累及、肺气肿、肺不张、支气管扩张、支气管播散病灶、渗出性病变、增值性病变、钙化均为耐药肺结核的独立危险因素。结论 对耐药肺结核病例与非耐药肺结核病例的胸部CT影像展开系统分析，可为疑似耐药肺结核患者提供影像学资料的依据，及时争取评估患者的耐药性，缩短诊治时间，提高早期诊断性以及治疗方案，从而改善患者的预后。更多还原

【Abstract】 Objective The aim of this study is to deeply analyze the clinical and imaging features of chest CT in patients with drug-resistant tuberculosis and non-drug-resistant tuberculosis, and to provide imaging evidence of reference value for the diagnosis of clinical suspected drug-resistant tuberculosis cases through systematic comparison and analysis. Methods A total of 68 patients with pulmonary tuberculosis admitted to Shangqiu Chest Hospital from May 2022 to May 2023 were selected. According to the data collected, the research objects were divided into two groups, with 34 cases in each group. The control group was non-drug-resistant pulmonary tuberculosis, and the study group was drug-resistant pulmonary tuberculosis. Results(1)Comparison of clinical data between the two groups, treatment type and intermittent medication history, statistically significant(P<0.05);(2)Comparison of CT imaging data between two groups showed that there was statistical significance(P<0.05) in terms of total lung involvement(CT involvement of lung location and number of lobes), airway lesions(emphysema, atelectasis, bronchiectasis, bronchial dissemination lesions), intrapulmonary lesions(exudative lesions, proliferative lesions, calcification, cavities), and comorbidities(destroyed lungs, pneumoconiosis); in the comparison of outcomes, the number of outcomes between the study group and the control group was 18 and 26, respectively. In terms of no changes and progression, the study group was significantly higher than the control group, but the number of outcomes in the control group was better than that in the study group, with statistical significance(P<0.05) Whole lung involvement, emphysema, atelectasis, bronchiectasis, bronchial disseminated lesions, exudative lesions, proliferative lesions, and calcification are all independent risk factors for drug-resistant pulmonary tuberculosis. Conclusion Analyzing the clinical manifestations of drug-resistant pulmonary tuberculosis and non drug-resistant pulmonary tuberculosis chest CT can provide imaging data for suspected drug-resistant pulmonary tuberculosis patients, timely evaluate patient drug resistance, shorten diagnosis and treatment time, improve early diagnosis and treatment plan, and thus improve patient prognosis.更多还原