ISSN 1004-4140
CN 11-3017/P

糖尿病患者肺部新型冠状病毒感染HRCT特点

梁玉红, 钟溪溪, 姚新群, 黄诗淇, 骆丽安, 吕亚萍

梁玉红, 钟溪溪, 姚新群, 等. 糖尿病患者肺部新型冠状病毒感染HRCT特点[J]. CT理论与应用研究, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031.
引用本文: 梁玉红, 钟溪溪, 姚新群, 等. 糖尿病患者肺部新型冠状病毒感染HRCT特点[J]. CT理论与应用研究, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031.
LIANG Y H, ZHONG X X, YAO X Q, et al. High-resolution Computed Tomography (HRCT) Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients with Diabetes[J]. CT Theory and Applications, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031. (in Chinese).
Citation: LIANG Y H, ZHONG X X, YAO X Q, et al. High-resolution Computed Tomography (HRCT) Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients with Diabetes[J]. CT Theory and Applications, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031. (in Chinese).

糖尿病患者肺部新型冠状病毒感染HRCT特点

详细信息
    作者简介:

    梁玉红: 女,广西柳州市柳铁中心医院放射科住院医师,主要从事影像诊断工作,E-mail:236693938@qq.com

    通讯作者:

    吕亚萍: 女,广西柳州市柳铁中心医院放射科主任、主任医师,主要从事影像诊断工作,E-mail:13977287067@126.com

  • 中图分类号: R  814;R  563.1

High-resolution Computed Tomography (HRCT) Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients with Diabetes

  • 摘要: 目的:探讨糖尿病患者肺部新型冠状病毒感染(COVID-19)HRCT特点。材料与方法:收集2022年12月14日至2023年1月10日确诊COVID-19且胸部CT表现异常的患者584例,男359例、女225例,年龄范围60~99岁,平均年龄(76±9)岁。其中合并糖尿病225例,非糖尿病359例;比较糖尿病患者COVID-19胸部HRCT与非糖尿病患者COVID-19胸部HRCT表现不同;定义发病与CT检查时间间隔<7d为急性期,363例入组患者,分析急性期糖尿病组与非糖尿病组新型冠状病毒肺炎(COVID-19)HRCT特点。结果:糖尿病患者COVID-19胸部感染与非糖尿病患者COVID-19胸部感染两组肺内病变在发病部位、分布、形态及伴随征象差异无统计学意义。两组病变在密度(细网格、病变密度不均匀)及病变边缘(病变边缘模糊)差异有统计学意义。无糖尿病组的肺部影像网格、不均匀和模糊征象显著高于有糖尿病组。其中细网格影:糖尿病组54例(24%),非糖尿病组127例(35.38%);密度不均匀:糖尿病组181例(80.44%),非糖尿病组313例(87.19%);边缘模糊:糖尿病组205例(91.11%),非糖尿病组344(95.82%)。急性期糖尿病组患者肺内网格影明显少于非糖尿病组患者,糖尿病组35例(24.65%),非糖尿病组82例(37.10%),差异有统计学意义。结论:糖尿病患者肺部新型冠状病毒感染(COVID-19)胸部HRCT病变渗出为主、密度均匀、边缘清晰,较非糖尿病组间质改变不明显。
    Abstract: Objective: To explore the characteristics of high-resolution computed tomography (HRCT) in diabetes complicated with coronavirus disease 2019 (COVID-19)-associated pneumonia. Materials and Methods: This study included 584 patients (359 males and 225 females), aged between 60~99 years old (mean, (76±9) years), with positive chest computed tomography (CT) findings and diagnosed with COVID-19 in our hospital from December 14, 2022, to January 10, 2023. Of these, 225 patients were diabetic and 359 were non-diabetic. The features of the chest HRCT from patients with diabetes mellitus complicated with COVID-19 and those without diabetes mellitus complicated with COVID-19 were compared. Moreover, 363 patients in the acute stage of COVID-19 (defined as the time interval between onset and CT examination <7 days) were selected for subgroup analysis, and the HRCT characteristics of COVID-19 between the diabetes group and the non-diabetic group in the acute stage. Results: The location, distribution, morphology, and concomitant signs of pulmonary lesions between the two groups of patients with COVID-19 did not differ significantly. Conversely, statistically significant differences in density (fine mesh, uneven density) and lesion margin (fuzzy lesion margin) were detected. In particular, the grid, uneven, and fuzzy signs on lung imaging were significantly higher in the non-diabetic group than that in the diabetic group. Additionally, 54 patients (24%) in the diabetic group and 127 patients (35.38%) in the non-diabetic group demonstrated fine mesh shadows. There were 181 patients (80.44%) in the diabetic group and 313 patients (87.19%) in the non-diabetic group with uneven density. Furthermore, 205 patients (91.11%) in the diabetic group and 344 patients (95.82%) in the non-diabetic group had blurred edges. There was significantly less pulmonary grid shadowing in the acute subgroup with diabetes (35, 24.65%) than in the acute subgroup without diabetes (82, 37.10%). Conclusion: The features of chest HRCT in patients with diabetes mellitus and COVID-19 are mainly exudation, uniform density, and a clear edge, while the interstitial changes are not obvious compared with patients in the non-diabetic group.
  • 图  1   男性,63岁,发热3 d,无糖尿病,HRCT显示双肺外周胸膜下GGO,密度不均匀,部分病灶边缘模糊

    Figure  1.   A 63-year-old man, a patient without diabetes mellitus, presented with a fever for 3 days, HRCT demonstrates peripheral subpleural ground glass opacities (GGO) in both lungs, with some lesions showing uneven density and blurred edges

    图  2   女,65岁,糖尿病病史9年,餐后血糖控制不佳,咳嗽3 d肺内多发实变样,病变边缘清晰

    Figure  2.   A 65-year-old female with a history of diabetes for 9 years and elevated blood sugar after meals, presented with a cough for 3 days. HRCT shows multiple lung lesions with clear lesion edges

    表  1   有无糖尿病两组患者的HRCT表现特征一览表

    Table  1   HRCT features in patients with and without diabetes mellitus

    项目组别统计检验
    无糖尿病/例(%)有糖尿病/例(%)$\chi^2 $P
    病变数量 多发359(100.00)224(99.50)1.5900.206
    累及部位 单叶3(0.84)0(0.00)1.8900.169
     单肺7(1.95)2(0.89)1.0260.311
     双肺351(97.77)220(97.78)0.0000.996
    病变分布 周围(胸膜下)114(31.75)83(36.89)1.6310.202
     中央(血管周)6(1.67)6(2.67)0.6810.409
     混合性239(66.57)137(60.89)1.9490.163
    病变形态 结节(1 cm)159(44.29)109(48.44)0.9620.327
     斑片状(3 cm)275(76.60)178(79.11)0.5010.479
     大片状(>3 cm)240(66.85)149(66.22)0.0250.875
    病变密度 GGO314(87.47)189(84.00)1.3900.238
     实变41(11.42)37(16.44)3.0170.082
     网格影127(35.38)54(24.00)8.3690.004**
     不均匀313(87.19)181(80.44)4.8230.028**
     均匀77(21.45)59(26.22)1.7640.184
    病变边缘 模糊344(95.82)205(91.11)5.4480.020*
     清晰19(5.29)18(8.00)1.7090.191
    伴随病变 血管增粗26(7.24)25(11.11)2.5970.107
     胸膜增厚203(56.55)130(57.78)0.0860.770
     胸水形成54(15.04)27(12.00)1.0710.301
    注:*-P<0.05,**-P<0.01。
    下载: 导出CSV

    表  2   COVID-19急性期糖尿病患者与非糖尿病患者的临床信息

    Table  2   Clinical information on patients with and without diabetes in the acute phase of COVID-19

    项目组别统计检验
    无糖尿病(n=221)有糖尿病(n=142)tP
    发病时间/d 4.74±2.12 4.45±2.281.2110.227
    年龄   78.00±9.3775.85±8.632.2030.028*
    注:急性期定义为发病时间<7 d。*-P<0.05。
    下载: 导出CSV

    表  3   COVID-19急性期糖尿病患者与非糖尿病患者的HRCT特征一览表

    Table  3   HRCT characteristics in patients with and without diabetes in the acute phase of COVID-19

    项目特征组别统计检验
    无糖尿病(n=221)
    /
    例(%)
    有糖尿病(n=142)
    /
    例(%)
    $\chi^2 $P
    病变数量  多发221(100.00)141(99.50)1.5900.206
    累及部位  单肺6(2.71)2(1.41)0.6850.408
      双肺214(96.83)138(97.18)0.0360.849
    病变分布  周围(胸膜下)65(29.41)49(34.51)1.0420.307
      中央(血管周)5(2.26)5(3.52)0.5110.475
      混合性153(69.23)90(63.38)1.3770.248
    病变形态  结节/树丫(1 cm)86(38.91)63(44.37)1.0620.303
      斑片状(3 cm)161(72.85)110(77.46)0.9730.324
      大片状(>3 cm)157(71.04)100(70.42)0.0160.899
    病变密度  GGO190(85.97)121(85.21)0.0410.840
      实变30(13.57)28(19.72)2.4310.119
      网格影82(37.10)35(24.65)6.1410.013*
      不均匀188(85.07)117(82.39)0.4600.497
      均匀49(22.17)38(26.76)0.9990.318
    病变边缘  模糊212(95.93)130(91.55)3.0410.081
      清晰11(4.98)11(7.75)1.1640.281
    伴随病变  血管增粗17(7.69)18(12.68)2.4650.116
      胸膜增厚129(58.37)85(59.86)0.0790.779
      胸水形成35(15.84)20(14.08)0.2070.649
    注:*-P<0.05。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2023-02-28
  • 修回日期:  2023-04-26
  • 录用日期:  2023-04-27
  • 网络出版日期:  2023-05-30
  • 发布日期:  2023-09-21

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