COVID-19 肺炎后长期多层计算机断层扫描显示的肺部宏观结构

Q4 Medicine

Pulmonologiya Pub Date : 2023-12-11 DOI:10.18093/0869-0189-2023-33-6-772-780

P. M. Kotlyarov, D. G. Soldatov, I. D. Lagkueva, Z. S. Tsallagova, V. A. Solodkiy

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引用次数: 0

摘要

该研究利用MSCT监测数据，旨在研究COVID-19（COronaVIrus Disease 2019）相关肺炎后长期（长达2年）肺部残留变化的符号学。对2020-2021年确诊为COVID-19相关肺炎的146名患者的胸部器官MSCT数据以及随后直至2023年的MSCT监测数据进行了对比分析。MSCT使用64排计算机断层扫描仪进行，数据在工作站上进行后处理。根据分析结果，确定了病毒性肺炎严重程度和肺部病变发生率不同的 4 组患者。第一组患者的疗效最好。在 90% 的病例中，病毒性肺炎的后果在观察第二年肺组织的宏观变化方面已完全消除。第二组主要由老年人组成，第一年均有 27 例（52.94%）患者，第二年有 33 例（64.7%）患者的肺组织宏观结构得到恢复。这组患者表现出纤维索、网状结构变化、胸膜反应和残留病灶（"磨玻璃"）。在第 3 组患者中也观察到了类似的趋势，但情况更为严重。40 名患者（86.95%）的残留病变与第 2 组（中老年和老年人）类似，但增加了支气管壁增厚和支气管扩张。在 9 名有 COVID-19 肺炎非典型表现的患者中，只有 2 人（22.22%）出现了网状封闭、纤维索、胸膜局部增厚和淋巴结肿大等 "疯狂铺路 "的变化，并持续观察了 2 年。对 COVID-19 相关肺炎患者痊愈后 2 年的肺部 MSCT 监测显示，COVID 后肺部变化的发生率和严重程度取决于疾病的严重程度（肺实质损伤的程度和性质）和患者的年龄。

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The macrostructure of lungs on multislice computed tomography scans in the long-term period after COVID-19 pneumonia

The purpose of the study using MSCT monitoring data was to investigate the semiotics of residual changes in the lungs in the long-term period (up to 2 years) after pneumonia associated with COVID-19 (COronaVIrus Disease 2019).Methods. A comparative analysis of MSCT data of the chest organs was carried out in 146 patients with a confirmed diagnosis of COVID-19-associated pneumonia in 2020 – 2021 and subsequent MSCT monitoring data until 2023. MSCT was performed using a 64-slice computed tomography scanner with data post-processed on the workstation.Results. Based on the analysis, 4 groups of patients were identified that differed in the severity of viral pneumonia and the prevalence of lung lesions. The first group of patients had the most beneficial course. In 90% of cases, there was a complete resolution of the consequences of viral pneumonia in terms macroscopic changes in lung tissue by the second year of observation. In the second group, which consisted primarily of older people, 27 (52.94%) patients in year 1 and in 33 (64.7%) patients in year 2 showed a recovery of macrostructure. This group demonstrated fibrous cords, reticular changes, reactions of pleura, and residual lesions (“ground glass”). A similar trend, but in a more severe form, was observed in group 3 patients. 40 patients (86.95%) had residual changes similar to those in group 2 (middle, elderly age and older people) with the addition of bronchial wall thickening and bronchiectasis. Only in 2 (22.22%) of 9 patients with atypical manifestations of COVID-19 pneumonia in the form of “crazy paving” changes in the form of reticular seals, fibrous cords, localized thickening of the pleura and lymphadenopathy persisted up to 2 years of observation.Conclusion. MSCT monitoring of the lungs of patients suffering from COVID-19-associated pneumonia up to 2 years after recovery showed that the prevalence and severity of post-COVID changes in the lungs depends on the severity of the disease (degree and nature of damage to the pulmonary parenchyma) and the patient’s age.

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来源期刊

Pulmonologiya Medicine-Pulmonary and Respiratory Medicine

CiteScore

1.40

自引率

0.00%

发文量

期刊介绍： The aim of this journal is to state a scientific position of the Russian Respiratory Society (RRS) on diagnosis and treatment of respiratory diseases based on recent evidence-based clinical trial publications and international consensuses. The most important tasks of the journal are: -improvement proficiency qualifications of respiratory specialists; -education in pulmonology; -prompt publication of original studies on diagnosis and treatment of respiratory diseases; -sharing clinical experience and information about pulmonology service organization in different regions of Russia; -information on current protocols, standards and recommendations of international respiratory societies; -discussion and consequent publication Russian consensus documents and announcement of RRS activities; -publication and comments of regulatory documents of Russian Ministry of Health; -historical review of Russian pulmonology development. The scientific concept of the journal includes publication of current evidence-based studies on respiratory medicine and their discussion with the participation of Russian and foreign experts and development of national consensus documents on respiratory medicine. Russian and foreign respiratory specialists including pneumologists, TB specialists, thoracic surgeons, allergists, clinical immunologists, pediatricians, oncologists, physiologists, and therapeutists are invited to publish article in the journal.