Establishment of differential diagnosis of pathogen in various pulmonary infections with CT according to host's immunity

根据宿主免疫力建立多种肺部感染病原菌的CT鉴别诊断

• 批准号: 08671038
• 负责人: MURAYAMA Sadayuki
• 金额: $ 1.15万
• 依托单位: KyushuUNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671038/
• 关键词: Pulmonary infection; pneumonia; Compnted Tomography (CT); High resolution CT; host immunity

This research was planned to clarify a correlation between the immune states and HRCT findings in variety of pulmonary infections. For this purpose, HRCT was performed in patients with clinical and/or chest X-p suspicion of pulmonary infection of any kind. Within three days of HRCT, peripheral blood sampling was done. Patient's immune state was evaluated by lymphocyte count and subset, CD2/4/8 ratios, NK cell activity, lymphocyte reaction, lgG, lgM, lgA, C3, and C4.Pathogens of pulmonary infection was determined by smear, culture, and PCR of sputum and alveolar lavage, transbronchial biospy, and serum antigen and antibody level.In 68 patients, both HRCT and data of immune state were obtained. Pathogens were as follows : tuberculosis (TBC) : 36, atypical mycobacterium (AM) ; 18, pneumocystis carinii (PC) ; 5, fungus ; 4, bacteria ; 3, and mycoplasma ; 2. In TBC or AM, atypical or wider distrubution of abnormality was observed on HRCT in patients with a decreased cellular immunity. Atypical findings, such as consolidation, miliary nodules, pleural effusion, lymphadenopathy were more commonly seen rather than typical findings including centrilobular nodules, single cavitary nodule, tree in bud appearance that are characteristic in patients with normal immunity.

本研究旨在探讨肺部感染患者的免疫状态与HRCT表现之间的相关性。为此，对临床和/或胸部X-p疑似任何类型肺部感染的患者进行HRCT。在HRCT检查后3天内，采集外周血样本。通过淋巴细胞计数及亚群、CD 2/4/8比值、NK细胞活性、淋巴细胞反应、IgG、IgM、IgA、C3、C4等指标评价患者的免疫状态，通过痰涂片、痰培养、PCR、肺泡灌洗、经支气管镜活检、血清抗原及抗体水平等方法确定肺部感染病原体。病原体如下：结核病（TBC）：非典型分枝杆菌（AM）36例，卡氏肺孢子虫（PC）18例，真菌5例，细菌4例，支原体3例，结核分枝杆菌2例。在TBC或AM中，细胞免疫功能低下的患者在HRCT上观察到不典型或更广泛的异常分布。非典型表现如实变、粟粒性结节、胸腔积液、淋巴结肿大较典型表现如小叶中心型结节、单个空洞型结节、树芽样改变多见。

项目成果

薮内英剛・村山貞之: "宿主免疫脳に応じた肺感染症の起炎病原体のCTによる鑑別診断の確立" INNERVISION. 13・9. 48 (1998)

Hidetake Yabunouchi 和 Sadayuki Murayama：“根据宿主免疫脑建立肺部感染呼吸道病原体的 CT 鉴别诊断” INNERVISION 13・9.48 (1998)。

Hidetake Yabuuchi, Sadayuki Murayama: "Establishment of differential diagnosis of pathogen in various pulmonary infections with CT according to host's immunity." INNERVISION. 13・9. 48 (1998)

Hidetake Yabuuchi、Sadayuki Murayama：“根据宿主免疫力建立各种肺部感染的病原体鉴别诊断”13・9.48（1998）。