中国防痨杂志2026，Vol.48Issue(5)：670-676,7.DOI:10.19982/j.issn.1000-6621.20250420
初始胸部CT特征对非耐药肺结核患者抗结核疗效的预测价值
Predictive value of baseline chest CT features for anti-tuberculosis treatment outcomes in patients with non-drug-resistant pulmonary tuberculosis
摘要
Abstract
Objective:To investigate the predictive value of baseline chest CT imaging features for predicting treatment outcomes in patients with non-drug-resistant pulmonary tuberculosis during the treatment phase.Methods:A retrospective case-control study design was employed.Patients with non-drug-resistant pulmonary tuberculosis admitted at Tianjin University Haihe Hospital between July 2017 and April 2024 were enrolled.Patients were categorized into a poor prognosis group(n=118)based on treatment outcomes and matched with a good prognosis group(n=183).Differences in baseline chest CT features and clinical indicators between the two groups were systematically compared using univariate analysis and logistic regression analysis.An efficacy prediction model was subsequently constructed.The predictive performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results:Multivariate logistic regression analysis identified the following as independent risk factors for poor treatment prognosis:retreated tuberculosis(OR=6.257,95％CI:2.977-13.153,P＜0.001),baseline CT showing cavity(OR=1.994,95％CI:1.116-3.564,P=0.020),bronchiectasis(OR=3.610,95％CI:1.395-9.341,P=0.008),fibrous stripe(OR=1.889,95％CI:1.073-3.328,P=0.028),involvement of more than three lung lobes(OR=2.293,95％CI:1.241-4.237,P=0.008),and decreased serum creatinine(OR=3.074,95％CI:1.539-6.137,P=0.001).The final prediction model formula was established as:logit(p)=-2.327+1.834 ×(Retreated tuberculosis)+0.690 ×(Cavity)+1.284 ×(Bronchiectasis)+0.636 ×(Fibrous stripe)+0.830 ×(Involved lung lobes＞3)+1.123 ×(Decreased serum creatinine).The model achieved an area under the curve(AUC)of 0.808(95％CI:0.759-0.857).Conclusion:The prediction model constructed based on baseline chest CT imaging features combined with clinical indicators showed good predictive value for the treatment outcomes of patients with non-drug-resistant pulmonary tuberculosis.关键词
结核,肺/预后/因素分析,统计学/危险因素/体层摄影术,X线计算机Key words
Tuberculosis,pulmonary/Prognosis/Factor analysis,statistical/Risk factors/Tomography,X-ray computed分类
医药卫生引用本文复制引用
赵小婷,韩晶,侯志丽,丁文龙,张宇洋,张硕,邢志珩..初始胸部CT特征对非耐药肺结核患者抗结核疗效的预测价值[J].中国防痨杂志,2026,48(5):670-676,7.基金项目
天津市教委科研计划项目(2024ZX009) Tianjin Municipal Education Commission Scientific Research Plan Project(2024ZX009) （2024ZX009）
