特发性肺间质纤维化是否合并肺气肿患者的临床特征对比分析  

Analysis of clinical characteristics between patients with idiopathic pulmonary fibrosis combined with emphysema and without emphysema

作　　者：吴允萍 刘巍 周之贺 王东 马文娟 

机构地区：[1]兰州市第一人民医院呼吸科,730050

出　　处：《中国医师进修杂志》2014年第28期27-30,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：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.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.

关 键 词：肺纤维化 肺气肿 临床特征 呼吸功能试验 

分 类 号：R563[医药卫生—呼吸系统]