目的 探讨CT联合炎性因子检测对单发局灶球形肺炎(solitary localized spherical pneumonia,SLSP)的诊断价值.方法 选取本院2015年12月至2016年12月收治的50例SLSP患者、50例肺癌患者及20例结核球患者为研究对象.分别对患者进行血常规、CT及X线检查,分析炎性因子检测联合CT检查对SLSP的诊断价值.结果 2 cm≤病灶直径<6 cm和病灶直径≥6 cm患者的白细胞计数、中性粒细胞百分比及C反应蛋白(C-reactive protein,CRP)水平均显著高于病灶直径<2 cm患者(P<0.05);病灶直径≥6 cm患者的白细胞计数、中性粒细胞百分比及CRP水平均显著高于2 cm≤病灶直径<6 cm患者(P<0.05).不同病灶直径的SLSP患者红细胞沉降率(erythrocyte sedimentation rate,ESR)比较均无显著差异(P>0.05).SLSP患者的白细胞计数、中性粒细胞百分比、CRP水平及ESR均显著高于结核球和肺癌患者(P<0.05).CT对左肺叶、右肺上叶、右肺下叶的SLSP病灶的检出率与X线比较均无显著差异(P>0.05);但当病灶处于右肺中叶时,CT的检出率显著高于X线(P<0.05).CT联合炎性因子检测对病灶直径<2 cm的SLSP的检出率显著高于单一CT检查或炎性因子检测的检出率(P<0.05);当病灶直径≥2 cm时,单用CT检查或炎性因子检测或联合检测的检出率比较均无显著差异(P>0.05).结论 SLSP患者炎性因子水平明显升高,且CT对其诊断价值明显高于X线检查,因此,临床中应采用CT联合炎性因子检测,提高SLSP的准确诊断率.%Objective To explore the diagnostic value of CT combined with inflammatory factors examination in the diagnosis of solitary localized spherical pneumonia (SLSP).Method 50 cases of SLSP patients, 50 cases of lung cancer patients, 20 cases of tuberculoma patients in our hospital from December 2015 to December 2016 were selected as research objects. All the patients had taken blood routine examination and CT detection to compared and analyzed the effect of inflammatory factors examination and CT detection on the detection rate of solitary localized spherical pneumonia.Result The white blood cell count, percentage of neutrophils, C-reactive protein (CRP) levels of 2 cm≤ lesion diameter<6 cm patients and lesion diameter≥ 6 cm patients were significantly higher than lesion diameter<2 cm patients (P<0.05). The white blood cell count, percentage of neutrophils, CRP levels of lesion diameter≥ 6 cm patients were significantly higher than 2 cm≤ lesion diameter<6 cm patients (P<0.05). There were no significant differences in erythrocyte sedimentation rate (ESR) among SLSP patients with different diameter of lesions (P>0.05). The white blood cell count, percentage of neutrophils, CRP, ESR in patients of SLSP were significance higher than the lung cancer patients and tuberculoma patients (P<0.05). Compared with X-ray, SLSP located in on the CT detection rate of the left lobe, superior lobe of right lung and inferior lobe of right lung showed no significant differences (P>0.05); but when the lesion in the middle lobe of right lung, the detection rate of CT was significantly higher than that of X-ray (P<0.05). The detection rate in CT detection combined with inflammatory factors examination on lesion diameter<2 cm was significantly higher than the inflammatory factors examination only or CT detection only (P<0.05). When the lesion diameter≥ 6 cm, single CT detection or inflammatory factor examination or joint detection rate showed no significant difference (P>0.05).Conclusion The level of inflammatory factors in patients with SLSP is obviously higher, and the diagnostic value of CT is obviously better than that of X-ray. Therefore, CT combined with inflammatory factors is worth promoting in clinic to improve the diagnostic rate of solitary localized spherical pneumonia.
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