国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2012年
12期
891-895
,共5页
肺纤维化%肺气肿%肺纤维化合并肺气肿
肺纖維化%肺氣腫%肺纖維化閤併肺氣腫
폐섬유화%폐기종%폐섬유화합병폐기종
Pulmonary fibrosis%Pulmonary emphysema%Combined pulmonary fibrosis and emphysema
目的 探讨肺纤维化合并肺气肿综合征临床特点、诊断标准及影像学表现,并提高对其认识.方法 分析2008年10月至2011年5月收治的3例肺纤维化合并肺气肿综合征病例临床特点、肺功能及影像学表现,并复习国内外文献.结果 3例患者均为重度吸烟的老年男性,均以活动后呼吸困难为主要表现.胸部CT表现为下肺纤维化及上肺野肺气肿,肺功能表现为第1秒用力呼气容积、用力肺活量及肺总量轻度下降而一氧化碳弥散功能重度下降.其中2例合并肺动脉高压.经治疗后咳嗽及喘息症状能够缓解,但肺弥散功能改善不明显.结论 诊断肺纤维化合并肺气肿综合征主要依赖胸部高分辨率CT,其特点为同时存在上肺野肺气肿和下肺野纤维化.肺功能表现为肺总量基本正常而弥散功能显著下降.临床治疗能部分缓解症状但难以改善肺弥散功能.肺纤维化合并肺气肿综合征发病机制、治疗及预后仍有待进一步研究.
目的 探討肺纖維化閤併肺氣腫綜閤徵臨床特點、診斷標準及影像學錶現,併提高對其認識.方法 分析2008年10月至2011年5月收治的3例肺纖維化閤併肺氣腫綜閤徵病例臨床特點、肺功能及影像學錶現,併複習國內外文獻.結果 3例患者均為重度吸煙的老年男性,均以活動後呼吸睏難為主要錶現.胸部CT錶現為下肺纖維化及上肺野肺氣腫,肺功能錶現為第1秒用力呼氣容積、用力肺活量及肺總量輕度下降而一氧化碳瀰散功能重度下降.其中2例閤併肺動脈高壓.經治療後咳嗽及喘息癥狀能夠緩解,但肺瀰散功能改善不明顯.結論 診斷肺纖維化閤併肺氣腫綜閤徵主要依賴胸部高分辨率CT,其特點為同時存在上肺野肺氣腫和下肺野纖維化.肺功能錶現為肺總量基本正常而瀰散功能顯著下降.臨床治療能部分緩解癥狀但難以改善肺瀰散功能.肺纖維化閤併肺氣腫綜閤徵髮病機製、治療及預後仍有待進一步研究.
목적 탐토폐섬유화합병폐기종종합정림상특점、진단표준급영상학표현,병제고대기인식.방법 분석2008년10월지2011년5월수치적3례폐섬유화합병폐기종종합정병례림상특점、폐공능급영상학표현,병복습국내외문헌.결과 3례환자균위중도흡연적노년남성,균이활동후호흡곤난위주요표현.흉부CT표현위하폐섬유화급상폐야폐기종,폐공능표현위제1초용력호기용적、용력폐활량급폐총량경도하강이일양화탄미산공능중도하강.기중2례합병폐동맥고압.경치료후해수급천식증상능구완해,단폐미산공능개선불명현.결론 진단폐섬유화합병폐기종종합정주요의뢰흉부고분변솔CT,기특점위동시존재상폐야폐기종화하폐야섬유화.폐공능표현위폐총량기본정상이미산공능현저하강.림상치료능부분완해증상단난이개선폐미산공능.폐섬유화합병폐기종종합정발병궤제、치료급예후잉유대진일보연구.
Objective To analyze clinical characteristics,diagnostic standard and radiological appearance in patients with combined pulmonary fibrosis and emphysema(CPFE) syndrome,and to improve awareness of it.Methods The clinical features,lung function and radiological imaging of three patients with CPFE syndrome since October 2008 to May 2011 were reported and the literatures were reviewed.Results All patients were older men and heavy smokers.Dyspnea on exertion was the main clinical features.HRCT findings included emphysema predominantly at the upper lobes,while reticular opacities,honeycombing were in the lower lobes.Pulmonary function demonstrated that forced expiratory volume in one second,forced vital capacity and total lung capacity were slightly lower,and the carbon monoxide diffusion capacity was significantly impaired.Pulmonary hypertension was seen in two patients.The symptoms of asthma and cough significantly relieved after treatment,but the carbon monoxide diffusion capacity was unimproved.Conclusions CPFE syndrome can be diagnosed according HRCT findings including co-existence of lower lung fibrosis and upper lung emphysema.Patients with CPFE syndrome can present with nearly normal total lung capacity but a remarkable impairment in pulmonary diffusion capacity.Treatment is effective for relieving clinical symptoms but not improving the lung diffusion capacity.Further studies to elucidate the pathogenesis and to explore the treatment and prognosis are warranted.
