中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
28期
27-30
,共4页
吴允萍%刘巍%周之贺%王东%马文娟
吳允萍%劉巍%週之賀%王東%馬文娟
오윤평%류외%주지하%왕동%마문연
肺纤维化%肺气肿%临床特征%呼吸功能试验
肺纖維化%肺氣腫%臨床特徵%呼吸功能試驗
폐섬유화%폐기종%림상특정%호흡공능시험
Pulmonary fibrosis%Emphysema%Clinical features%Respiratory function tests
目的 探讨特发性肺间质纤维化(IPF)是否合并肺气肿患者的临床特点、肺功能、影像学及其预后的差异.方法 选择IPF且符合肺纤维化合并肺气肿(CPFE)诊断的患者43例(观察组),选择同期确诊的单纯IPF未合并肺气肿患者40例(对照组),对比分析两组患者的临床资料、肺功能、血氧分压、支气管肺泡灌洗液(BALF)细胞成分及生存时间的差异.结果 观察组吸烟指数为(29±17)包年,明显高于对照组的(17± 15)包年,差异有统计学意义(P＜0.05).观察组第1秒用力呼气容积(FEV1)/用力肺活量(FVC)占预计值百分比为(70±6)％,明显低于对照组的(84±9)％,差异有统计学意义(P＜0.05);观察组一氧化碳弥散量(DLCO)占预计值百分比为(43±11)％,明显低于对照组的(55±17)％,差异有统计学意义(P＜0.05).观察组肺总量占预计值百分比(78±12)％,明显高于对照组的(63±11)％,差异有统计学意义(P＜0.05),两组肺活量占预计值百分比及静息状态下动脉血氧分压比较差异无统计学意义(P＞0.05).两组BALF细胞总数、巨噬细胞、中性粒细胞、淋巴细胞及嗜酸粒细胞百分率比较差异无统计学意义(P＞0.05).结论 吸烟为IPF合并肺气肿的重要危险因素,合并肺气肿不影响IPF患者的预后.
目的 探討特髮性肺間質纖維化(IPF)是否閤併肺氣腫患者的臨床特點、肺功能、影像學及其預後的差異.方法 選擇IPF且符閤肺纖維化閤併肺氣腫(CPFE)診斷的患者43例(觀察組),選擇同期確診的單純IPF未閤併肺氣腫患者40例(對照組),對比分析兩組患者的臨床資料、肺功能、血氧分壓、支氣管肺泡灌洗液(BALF)細胞成分及生存時間的差異.結果 觀察組吸煙指數為(29±17)包年,明顯高于對照組的(17± 15)包年,差異有統計學意義(P＜0.05).觀察組第1秒用力呼氣容積(FEV1)/用力肺活量(FVC)佔預計值百分比為(70±6)％,明顯低于對照組的(84±9)％,差異有統計學意義(P＜0.05);觀察組一氧化碳瀰散量(DLCO)佔預計值百分比為(43±11)％,明顯低于對照組的(55±17)％,差異有統計學意義(P＜0.05).觀察組肺總量佔預計值百分比(78±12)％,明顯高于對照組的(63±11)％,差異有統計學意義(P＜0.05),兩組肺活量佔預計值百分比及靜息狀態下動脈血氧分壓比較差異無統計學意義(P＞0.05).兩組BALF細胞總數、巨噬細胞、中性粒細胞、淋巴細胞及嗜痠粒細胞百分率比較差異無統計學意義(P＞0.05).結論 吸煙為IPF閤併肺氣腫的重要危險因素,閤併肺氣腫不影響IPF患者的預後.
목적 탐토특발성폐간질섬유화(IPF)시부합병폐기종환자적림상특점、폐공능、영상학급기예후적차이.방법 선택IPF차부합폐섬유화합병폐기종(CPFE)진단적환자43례(관찰조),선택동기학진적단순IPF미합병폐기종환자40례(대조조),대비분석량조환자적림상자료、폐공능、혈양분압、지기관폐포관세액(BALF)세포성분급생존시간적차이.결과 관찰조흡연지수위(29±17)포년,명현고우대조조적(17± 15)포년,차이유통계학의의(P＜0.05).관찰조제1초용력호기용적(FEV1)/용력폐활량(FVC)점예계치백분비위(70±6)％,명현저우대조조적(84±9)％,차이유통계학의의(P＜0.05);관찰조일양화탄미산량(DLCO)점예계치백분비위(43±11)％,명현저우대조조적(55±17)％,차이유통계학의의(P＜0.05).관찰조폐총량점예계치백분비(78±12)％,명현고우대조조적(63±11)％,차이유통계학의의(P＜0.05),량조폐활량점예계치백분비급정식상태하동맥혈양분압비교차이무통계학의의(P＞0.05).량조BALF세포총수、거서세포、중성립세포、림파세포급기산립세포백분솔비교차이무통계학의의(P＞0.05).결론 흡연위IPF합병폐기종적중요위험인소,합병폐기종불영향IPF환자적예후.
Objective To investigate the differences of clinical features,pulmonary function tests,chest imaging and prognosis between patients with idiopathic pulmonary fibrosis (IPF) combined with emphysema and without emphysema.Methods A total of 43 patients with IPF and with pulmonary fibrosis and emphysema (CPFE) were selected as observation group,and 40 patients with IPF and without emphysema were selected as control group.The clinical data of two groups of patients,including pulmonary function,partial pressure of oxygen,cellular components of bronchoalveolar lavage fluid (BALF),survival time were retrospectively analyzed and compared between two groups.Results The smoking index was (29 ± 17) pack years in observation group,much higher than that in control group (17 ± 15) pack years,the difference was statistically significant (P ＜ 0.05).The percentage of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was (70 ± 6)％ in observation group,significantly lower than that in control group (84 ± 9)％,the difference was statistically significant (P ＜ 0.05).The percentage of diffusion capacity of carbon monoxide (DLCO) in observation group was (43 ± 11)％,significantly lower than that in control group (55 ± 17)％,the difference was statistically significant (P ＜ 0.05).The percentage of lung volume in observation group was (78 ± 12)％,significantly higher than that in control group (63 ± 11)％,the difference was statistically significant (P ＜0.05).The vital capacity was expected to account for partial pressure had no significant difference in percentage and resting arterial oxygen value between two groups (P ＞ 0.05).The total number of BALF cells,macrophages,neutrophils,lymphoeytes and eosinophils ratio had no significant difference between two groups (P ＞ 0.05).Conclusion Smoking is an important risk factor of IPF with emphysema,emphysema does not affect the prognosis of patients with IPF.
