肺纤维化合并肺气肿与特发性肺纤维化的临床特征比较分析  

Clinical Analysis of Patients with Combined Pulmonary Fibrosis and Emphysema in Comparison with Idiopathic Pulmonary Fibrosis

作　　者：陈锋[1] 张磊[1] 唐家璇[1] 韩雪峰[1] 乜庆荣[1] 

机构地区：[1]首都医科大学良乡教学医院呼吸内科,北京市102401

出　　处：《医学理论与实践》2016年第10期1263-1265,1270,共4页The Journal of Medical Theory and Practice

摘　　要：目的：探讨肺纤维化合并肺气肿（CPFE）的临床特征,并与特发性肺纤维化（IPF）进行比较。方法：回顾性分析我院2010年1月-2015年12月住院诊断为CPFE及IPF患者47例,其中CPFE组21例,IPF组26例,分析两组的人口学特征、临床表现、肺功能、心脏超声及血气分析等。结果：CPFE组患者病程较IPF组长[59.0（17.5~152.5）个月VS 16.0（9.0~30.0）个月,P=0.001],吸烟指数较IPF组高[（599.00±146.79）年支VS（431.43±139.80）年支,P=0.001],体重指数（BMI）较IPF组低（19.49±3.64）VS（23.04±4.07）,P=0.003）,两组间性别、年龄无明显差异;临床表现方面,CPFE组咳痰、P2〉A2均较IPF组多（P〈0.05）,IPF组Velcro啰音较CPFE组多（23/26VS 10/21,P=0.005）。肺功能方面,CPFE组FVC%pred、TLC%pred明显高于IPF组（P〈0.05）,而FEV1/FVC、DLCO%pred则明显低于IPF组（P〈0.05）;CPFE组合并肺动脉高压（PAH）者12例明显高于IPF组6例（P=0.017）,CPFE组PCO2高于IPF组[（48.00±5.61）mmHg VS（39.08±3.34）mmHg,P=0.000],两组间动脉氧分压无明显差异,预后方面,CPFE组中位生存时间为（44.0±8.8）个月,IPF组为（36.0±2.9）个月,两组间无明显差异（P=0.748）。结论：与IPF患者相比,CPFE患者病程较长,体重指数偏低,肺容积偏于正常而弥散功能降低更为明显,易合并肺动脉高压,而预后无明显差异。Objective：To explore the differences between patients with combined fibrosis and emphysema（CPFE）in comparison with idiopathic pulmonary fibrosis（IPF）.Methods：We retrospectively analyzed 47 patients diagnosed as CPFE or IPF for the first time from January 2010 to December 2015,21 cases met the diagnostic criteria of CPFE and26 cases for IPF.The differences in demographic characteristics,clinical manifestations,pulmonary function tests,pulmonary artery pressures and some parameters of arterial blood gas analysis between the two groups were analyzed.Results：The clinical course of CPFE group were significantly longer than IPF group[59.0（17.5~152.5）months VS 16.0（9.0~30.0）months,P=0.001],the smoking index in CPFE group was higher than IPF group（599.00±146.79VS431.43±139.80,P=0.001）,the body mass index（BMI）in CPFE group was lower than IPF group（19.49±3.64VS23.04±4.07,P=0.003）,however,there were no significant differences in age and gender between the two groups.The FVC%pred,TLC%pred were significantly higher in CPFE group than IPF group（P〈0.05）and the FEV1/FVC,DLCO%pred were lower than IPF group（P〈0.05）.The incidence of pulmonary artery hypertension in CPFE group was significantly higher than IPF group（12/21 VS 6/26,P=0.017）and the PCO_2 were higher than IPF group[（48.00±5.61）mmHg VS（39.08±3.34）mmHg,P=0.000）].The median survival time in the CPFE was（44.0±8.8）months and（36.0±2.9）months,but no significantly differences were observed in the two groups.Conclusion：Compared with IPF,patients in CPFE group usually had a longer clinical course,lower BMI,a mild abnormality in the lung volume but a significantly decrease in the diffusing capacity,a more opportunity to catch pulmonary artery hypertension,but no significantly differences in survival time.

关 键 词：肺气肿 肺纤维化 临床特征 

分 类 号：R563[医药卫生—呼吸系统]