临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
1期
44-47
,共4页
肺纤维化%肺气肿%体征和症状%预后
肺纖維化%肺氣腫%體徵和癥狀%預後
폐섬유화%폐기종%체정화증상%예후
pulmonary fibrosis%pulmonary emphysema%sign and symptoms%prognosis
目的：比较老年特发性肺间质纤维化（IPF）与老年肺纤维化和肺气肿综合征（CPFE）的临床特点及预后差异。方法将我院呼吸内科收治的30例患者分为 IPF 组（13例）和 CPFE 组（17例），比较两组患者入院时的肺功能、血气资料、影像学、血清转化生长因子β（TGF-β1）、血管内皮生长因子（VEGF）及预后的差异。结果 CPFE 组与IPF 组的动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）比较差异无统计学意义（P ＞0．05）；CPFE 组的血氧饱合度（SaO2）低于 IPF 组、肺泡动脉氧分压差（P[A-a]O2）高于 IPF 组（P ＜0．05）；CPFE 组与 IPF 组的用力肺活量（FVC）、第1秒用力肺活量（FEV1）、肺总量（TLC）、FEV1／FVC 比较差异有统计学意义（P ＜0．05）；CPFE 组的 TGF-β1、VEGF 均显著的低于 IPF 组（P ＜0．05）。两组在蜂窝表现、支气管牵拉扩张、纵膈淋巴结肿大、肺纤维化评分几项指标上差异无统计学意义（P ＞0．05）；IPF 组的网格影表现显著高于 CPFE 组（P ＜0．05）；CPFE 组的中位生存时间为18．0个月，IPF 组的中位生存时间为23．0个月，IPF 组的中位生存时间显著长于 CPFE 组（χ2＝5．004，P ＜0．05）。结论 CPFE 患者与 IPF 患者的临床血气指标、TGF-β1、VEGF 等指标均有较为显著的差异，这有利于二者的鉴别诊断，同时 CPFE 患者的预后较 IPF 患者差。
目的：比較老年特髮性肺間質纖維化（IPF）與老年肺纖維化和肺氣腫綜閤徵（CPFE）的臨床特點及預後差異。方法將我院呼吸內科收治的30例患者分為 IPF 組（13例）和 CPFE 組（17例），比較兩組患者入院時的肺功能、血氣資料、影像學、血清轉化生長因子β（TGF-β1）、血管內皮生長因子（VEGF）及預後的差異。結果 CPFE 組與IPF 組的動脈血氧分壓（PaO2）、動脈血二氧化碳分壓（PaCO2）比較差異無統計學意義（P ＞0．05）；CPFE 組的血氧飽閤度（SaO2）低于 IPF 組、肺泡動脈氧分壓差（P[A-a]O2）高于 IPF 組（P ＜0．05）；CPFE 組與 IPF 組的用力肺活量（FVC）、第1秒用力肺活量（FEV1）、肺總量（TLC）、FEV1／FVC 比較差異有統計學意義（P ＜0．05）；CPFE 組的 TGF-β1、VEGF 均顯著的低于 IPF 組（P ＜0．05）。兩組在蜂窩錶現、支氣管牽拉擴張、縱膈淋巴結腫大、肺纖維化評分幾項指標上差異無統計學意義（P ＞0．05）；IPF 組的網格影錶現顯著高于 CPFE 組（P ＜0．05）；CPFE 組的中位生存時間為18．0箇月，IPF 組的中位生存時間為23．0箇月，IPF 組的中位生存時間顯著長于 CPFE 組（χ2＝5．004，P ＜0．05）。結論 CPFE 患者與 IPF 患者的臨床血氣指標、TGF-β1、VEGF 等指標均有較為顯著的差異，這有利于二者的鑒彆診斷，同時 CPFE 患者的預後較 IPF 患者差。
목적：비교노년특발성폐간질섬유화（IPF）여노년폐섬유화화폐기종종합정（CPFE）적림상특점급예후차이。방법장아원호흡내과수치적30례환자분위 IPF 조（13례）화 CPFE 조（17례），비교량조환자입원시적폐공능、혈기자료、영상학、혈청전화생장인자β（TGF-β1）、혈관내피생장인자（VEGF）급예후적차이。결과 CPFE 조여IPF 조적동맥혈양분압（PaO2）、동맥혈이양화탄분압（PaCO2）비교차이무통계학의의（P ＞0．05）；CPFE 조적혈양포합도（SaO2）저우 IPF 조、폐포동맥양분압차（P[A-a]O2）고우 IPF 조（P ＜0．05）；CPFE 조여 IPF 조적용력폐활량（FVC）、제1초용력폐활량（FEV1）、폐총량（TLC）、FEV1／FVC 비교차이유통계학의의（P ＜0．05）；CPFE 조적 TGF-β1、VEGF 균현저적저우 IPF 조（P ＜0．05）。량조재봉와표현、지기관견랍확장、종격림파결종대、폐섬유화평분궤항지표상차이무통계학의의（P ＞0．05）；IPF 조적망격영표현현저고우 CPFE 조（P ＜0．05）；CPFE 조적중위생존시간위18．0개월，IPF 조적중위생존시간위23．0개월，IPF 조적중위생존시간현저장우 CPFE 조（χ2＝5．004，P ＜0．05）。결론 CPFE 환자여 IPF 환자적림상혈기지표、TGF-β1、VEGF 등지표균유교위현저적차이，저유리우이자적감별진단，동시 CPFE 환자적예후교 IPF 환자차。
ABSTRACT:Objective To compare the clinical features and prognostic differences of idiopathic pulmonary interstitial fibrosis(IPF)in elderly patients with pulmonary fibrosis and emphysema syndrome(CPFE).Methods Thirty cases in our hospital were divided into group IPF (13 cases)and CPFE group (17 cases),comparison was performed in pulmonary function and blood gas data,the image,serum transforming growth factor beta(TGF-beta 1), vascular endothelial growth factor(VEGF)differences and prognosis of two groups.Results CPEE group compared with IPF group,arterial oxygen(PaO2 ),arterial carbon dioxide tension(PaCO2 )showed significant difference(P >0.05);oxygen saturation(SaO2 )in CPFE group was lower than that of IPF group,alveolar-arteri pressure(P[A-a]O2 ) higher than IPF group (P <0.05);CPFE group compared with PIF group,forced vital capacity(FVC),forced vital capatity in one second(FEV1 ),total lung capacity(TLC),FEV1/FVC had significant difference (P <0.05);TGF-β1 , VEGF in CPFE group were significantly lower than those of IPF group(P <0.05);the two groups had no significant difference in the cellular performance,bronchial dilation traction,mediastinal lymphadenopathy,pulmonary fibrosis score on several indicators (P >0.05);the grid shadow performance of IPF group was significantly higher than that of CPFE group (P <0.05);CPFE group,the median survival time of 18.0 months,with a median survival time of IPF group 23.0 months,the median survival time of IPF group was significantly longer than that of CPFE group (χ2 =5.004,P <0.05).Conclusion The difference of clinical blood gas indexes,TGF-beta,VEGF index of CPFE group in comparison with IPF group were significant,which is conducive to the differential diagnosis of the two diseases,at the same time,the prognosis of CPFE patients was poorer than that of IPF patients.
