目的 探讨胸部电子计算机断层 扫描(Computed Tomography，CT)对小儿 链球菌感染肺炎和支原体感染肺炎的鉴别 诊断价值。方法 选取枣阳市第一人民医 院和襄阳市中心医院2017年1月-2018年12 月收治的160例单一病原体感染的肺炎患 儿为研究对象并开展回顾性分析，依据 患者肺炎种类不同将以上研究对象分为 支原体组(100例)和链球菌组(60例)，所 有患者均于治疗前行CT扫描，比较两组 的CT影像学表现。结果 支原体组白细胞 计数水平显著低于链球菌组(P<0.05)，胸 腔积液厚度及淋巴结结影厚度显著小于链 球菌组(P<0.05)；支原体组的磨玻璃影、 小叶中心结节及弥漫性支气管壁增厚人数 比例显著高于链球菌组(P<0.05)，两组在 网状和线形模糊影、胸腔积液、淋巴结肿 大及实变等胸部CT表现方面比较无显著 差异(P>0.05)；支原体组一叶以上受累 率(72.00%)显著高于链球菌组(43.33%) (P<0.05)，两组的肺叶受累率比较无显著 差异(P>0.05)；两组肺内病变形态比较差 异具有显著性(P<0.05)。结论 胸部CT对 小儿链球菌感染肺炎和支原体感染肺炎具 有较好的鉴别诊断价值，可通过腔积液厚 度增厚、淋巴结结影厚度增厚、支气管壁 增厚及小叶中心结节等CT征象区分二者。

Objective The investigate value of computed tomography (CT) in the differential diagnosis of streptococcus infection pneumonia and mycoplasma infection pneumonia in children. Methods A total of 160 children with pneumonia infected by single pathogens during the period from January 2017 to December 2018 who were admitted to the hospital were selected. And retrospective analysis was conducted. The above subjects were divided into mycoplasma group (100 cases) and streptococcus group (60 cases) according to different types of pneumonia in the patients. All patients underwent CT scan before treatment. The imaging findings of CT were compared between the two groups. Results The white blood cell count of mycoplasma group was significantly lower than that of streptococcus group (P<0.05). The thickness of pleural effusion and thickness of lymph node nodule shadow were significantly smaller than those of streptococcus group (P<0.05). The ground-glass opacity, proportion of people with thickening of centrilobular nodules and diffuse bronchial wall in mycoplasma group were significantly higher than those in streptococcus group (P<0.05). There was no significant difference in chest CT findings such as reticular and linear fuzzy image, pleural effusion, lymphadenectasis or consolidation between the two groups (P> 0.05). The involved rate of more than 1 leaf in mycoplasma group was significantly higher than that in streptococcus group (72.00% vs 43.33%) (P<0.05). There was no significant difference in the involved rate of lung lobes between the two groups (P>0.05). There were significant differences in the morphology of intrapulmonary lesions between the two groups (P<0.05). Conclusion Chest CT is of relatively better differential diagnosis value for streptococcus infection pneumonia and mycoplasma infection pneumonia in children. The two kinds of pneumonia can be differentiated by CT signs such as thickening of pleural effusion thickness, thickening of lymph node nodule shadow, thickening of bronchial wall and centrilobular nodules.