中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2013年
3期
173-176
,共4页
马江伟%李振华%许慧%王慧娟%康健%于润江
馬江偉%李振華%許慧%王慧娟%康健%于潤江
마강위%리진화%허혜%왕혜연%강건%우윤강
肺纤维化%肺气肿%呼吸功能试验
肺纖維化%肺氣腫%呼吸功能試驗
폐섬유화%폐기종%호흡공능시험
Pulmonary fibrosis%Pulmonary emphysema%Respiratory function tests
目的 探讨特发性肺间质纤维化(IPF)合并肺气肿与未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 从2002年1月至2007年1月在中国医科大学附属第一医院首次确诊为IPF的117例患者中筛选出符合肺纤维化合并肺气肿(CPFE)诊断的患者23例(CPFE组),选取2002-2003年确诊的单纯IPF患者33例作为对照组,回顾性分析两组患者的临床资料、肺功能、血氧分压、BALF细胞成分及生存时间的差异.结果 (1)CPFE组吸烟指数为(28±18)包年,明显高于IPF组的(18±16)包年(t=2.10,P<0.05);两组性别、吸烟者比率及年龄差异无统计学意义.(2)CPFE组FEV1/FVC占预计值%为(77±7)%,明显低于IPF组的(83±8)%(t=3.55,P<0.05);CPFE组DLCO占预计值%为(44±12)%,明显低于IPF组的(54±16)%(t=2.48,P<0.05);CPFE组肺总量占预计值%明显高于IPF组[分别为(77±11)%和(64±12)%,t=3.93,P<0.05],肺活量及静息状态下血氧分压水平两组间无明显差异(均P >0.05).(3)两组间BALF细胞总数、巨噬细胞、中性粒细胞、淋巴细胞及嗜酸粒细胞比率无明显差异(均P >0.05).(4)两组中位生存时间差异无统计学意义[分别为(40±3)和(38±4)个月,x2 =0.65,P=0.79].结论 吸烟为IPF合并肺气肿的重要危险因素,IPF合并肺气肿患者的肺功能指标表现为肺容积轻度异常而弥散功能显著下降,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)閤併肺氣腫與未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 從2002年1月至2007年1月在中國醫科大學附屬第一醫院首次確診為IPF的117例患者中篩選齣符閤肺纖維化閤併肺氣腫(CPFE)診斷的患者23例(CPFE組),選取2002-2003年確診的單純IPF患者33例作為對照組,迴顧性分析兩組患者的臨床資料、肺功能、血氧分壓、BALF細胞成分及生存時間的差異.結果 (1)CPFE組吸煙指數為(28±18)包年,明顯高于IPF組的(18±16)包年(t=2.10,P<0.05);兩組性彆、吸煙者比率及年齡差異無統計學意義.(2)CPFE組FEV1/FVC佔預計值%為(77±7)%,明顯低于IPF組的(83±8)%(t=3.55,P<0.05);CPFE組DLCO佔預計值%為(44±12)%,明顯低于IPF組的(54±16)%(t=2.48,P<0.05);CPFE組肺總量佔預計值%明顯高于IPF組[分彆為(77±11)%和(64±12)%,t=3.93,P<0.05],肺活量及靜息狀態下血氧分壓水平兩組間無明顯差異(均P >0.05).(3)兩組間BALF細胞總數、巨噬細胞、中性粒細胞、淋巴細胞及嗜痠粒細胞比率無明顯差異(均P >0.05).(4)兩組中位生存時間差異無統計學意義[分彆為(40±3)和(38±4)箇月,x2 =0.65,P=0.79].結論 吸煙為IPF閤併肺氣腫的重要危險因素,IPF閤併肺氣腫患者的肺功能指標錶現為肺容積輕度異常而瀰散功能顯著下降,閤併肺氣腫不影響IPF患者的預後.
목적 탐토특발성폐간질섬유화(IPF)합병폐기종여미합병폐기종환자적림상특점、폐공능、영상학급기예후적차이.방법 종2002년1월지2007년1월재중국의과대학부속제일의원수차학진위IPF적117례환자중사선출부합폐섬유화합병폐기종(CPFE)진단적환자23례(CPFE조),선취2002-2003년학진적단순IPF환자33례작위대조조,회고성분석량조환자적림상자료、폐공능、혈양분압、BALF세포성분급생존시간적차이.결과 (1)CPFE조흡연지수위(28±18)포년,명현고우IPF조적(18±16)포년(t=2.10,P<0.05);량조성별、흡연자비솔급년령차이무통계학의의.(2)CPFE조FEV1/FVC점예계치%위(77±7)%,명현저우IPF조적(83±8)%(t=3.55,P<0.05);CPFE조DLCO점예계치%위(44±12)%,명현저우IPF조적(54±16)%(t=2.48,P<0.05);CPFE조폐총량점예계치%명현고우IPF조[분별위(77±11)%화(64±12)%,t=3.93,P<0.05],폐활량급정식상태하혈양분압수평량조간무명현차이(균P >0.05).(3)량조간BALF세포총수、거서세포、중성립세포、림파세포급기산립세포비솔무명현차이(균P >0.05).(4)량조중위생존시간차이무통계학의의[분별위(40±3)화(38±4)개월,x2 =0.65,P=0.79].결론 흡연위IPF합병폐기종적중요위험인소,IPF합병폐기종환자적폐공능지표표현위폐용적경도이상이미산공능현저하강,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 Of the 117 patients diagnosed as IPF for the first time in the First Affiliated Hospital of China Medical University from January 2002 to January 2007,23 cases met the diagnostic criteria for combined pulmonary fibrosis and emphysema (CPFE).Thirty-three cases with isolated IPF from 2002 to 2003 were selected as the control group.Clinical characteristics,pulmonary function indexes,PaO2,bronchoalveolar lavage fluid (BALF) results and survival time were retrospectively analyzed and compared between the 2 groups.Results The smoking indexes (pack-years) were significantly higher in the CPFE group(28 ± 18)compared with the IPF group (18 ± 16),t =2.10,P < 0.05.No significant difference was observed between the 2 groups in terms of age,gender and the percentage of smokers.The CPFE group showed significantly lower FEV1/FVC% [(77 ± 7) %,(83 ± 8) %,t =3.55,P < O.05] and DLCO% pred [(44 ± 12)%,(54 ± 16)%,t =2.48,P <0.05] compared to those of the IPF group,while TLC% pred was significantly higher in the CPFE group [(77 ± 11) %,(64 ± 12) %,t =3.93,P < 0.05].VC% pred and PaO2 showed no significant difference between the 2 groups.The total cell count,the percentages of macrophages,neutrophils,lymphocytes and eosinophils in BALF showed no significant difference between the 2 groups.There was no significant difference in median survival time between the 2 groups.Conclusion Smoking was an important risk factor for IPF combined with emphysema.The pulmonary function of IPF combined with emphysema is characterized by a mild abnormality in the lung volume but a significant decrease in the diffusing capacity.Combined emphysema has no influence on the survival time of patients with IPF.