上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

非活动性肺结核对肺纤维化合并肺气肿患者的影响

胡凤英1，涂静2，张燕2，黄勇1，周向东1   

  1. 1.重庆医科大学附属第二医院呼吸与危重症医学科， 重庆 400010； 2.重庆市中山医院呼吸中心， 重庆 400013
  • 出版日期:2015-03-28 发布日期:2015-03-26
  • 通讯作者: 黄勇, 电子信箱: yonhuang@163.com。
  • 作者简介:胡凤英(1988—)， 女， 硕士生; 电子信箱: yingohf@163.com。
  • 基金资助:

    重庆市卫计委科研课题(2011-2-372)

Effects of inactive pulmonary tuberculosis on patients with combined pulmonary fibrosis and emphysema

HU Feng-ying1, TU Jing2, ZHANG Yan2, HUANG Yong1, ZHOU Xiang-dong1   

  1. 1.Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China; 2.Respiratory Center, Chongqing Zhongshan Hospital, Chongqing 400013, China
  • Online:2015-03-28 Published:2015-03-26
  • Supported by:

    Project of Chongqing Health and Family Planning Commision， 2011-2-372

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摘要：

目的 探讨非活动性肺结核对肺纤维化合并肺气肿(CPFE)患者临床特征的影响。方法 采用胸部高分辨率CT(HRCT) 进行筛选，有非活动性肺结核表现的CPFE患者作为观察组(n=42)，仅符合CPFE表现的患者作为对照组(n=38)；采用视觉评分量化纤维化、肺气肿和非活动性肺结核。按非活动性肺结核评分将观察组再分为≥10分组(n=18)和<10分组(n=24)。比较各组血气分析指标、肺功能指标、HRCT表现和评分。结果 与对照组比较，观察组第一秒用力肺活量与用力肺活量的比值<70%的发生率较高(28/42)，25%的最大呼气流量和最大呼气中段流量较低，≥10分组还有50%最大呼气流量更低（均P<0.05）；各组间肺气肿评分、纤维化评分、动脉氧分压的差异无统计学意义(均P>0.05)。结论 非活动性肺结核可加重CPFE患者气流受限。

关键词: 肺纤维化, 肺气肿, 非活动性肺结核, 高分辨率CT, 肺功能

Abstract:

Objective To investigate the effects of inactive tuberculosis on the clinical features of patients with combined pulmonary fibrosis and emphysema (CPFE). Methods The high resolution computer tomography (HRCT) was adopted to screen the patients. Patients were divided into the observation group (CPFE patients with inactive pulmonary tuberculosis, n=42) and control group (CPFE patients, n=38). The visual semi-quantitative scoring system was employed to quantify fibrosis, emphysema, and inactive tuberculosis. According to scores of inactive pulmonary tuberculosis, the observation group was further divided into the ≥10 points group (n=18) and <10 points group (n=24). Indexes of arterial blood gas analysis, indexes of pulmonary function, and HRCT manifestation and scores of groups were compared. Results Compared with the control group, patients of the observation group whose ratios of forced expiratory volume in first second to forced vital capacity that were less than 70% were more (28/42), and the maximal expiratory flow of 25% vital capacity and maximal middle expiratory flow were lower. Furthermore, the maximal expiratory flow of 50% vital capacity of the ≥10 points group was even lower (P<0.05). The differences of the emphysema score, fibrosis score, and arterial oxygen pressure of groups were not statistically significant (P>0.05). Conclusion Inactive tuberculosis can aggravate the airflow obstruction of patients with CPFE.

Key words: pulmonary fibrosis, emphysema, inactive pulmonary tuberculosis, high resolution computer tomography, pulmonary function