126例肺结节病患者的临床特征及气道受累的相关因素  

Clinical characteristics and related factors of airway involvement in 126 patients with pulmonary sarcoidosis

作　　者：柏佳 宗秋 贾林杰 倪望[1] 许淑云[1] 赵建平[1] 徐永健[1] 周敏[1] Bai Jia;Zong Qiu;Jia Linjie;Ni Wang;Xu Shuyun;Zhao Jianping;Xu Yongjian;Zhou Min(Department of Respiratory Diseases and Critical Care Medicine,Tongji Hospital,Tongji Medical College,Huazhong university of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院呼吸与危重症医学科,武汉430030 [2]江苏省连云港市第一人民医院呼吸与危重症医学科

出　　处：《临床内科杂志》2023年第1期29-33,共5页Journal of Clinical Internal Medicine

基　　金：国家自然科学基金青年项目(81700032)。

摘　　要：目的探讨肺结节病患者的临床特征及气道受累的相关因素。方法根据气道受累与否,将126例肺结节病患者分为气道受累组69例和非气道受累组57例。比较两组患者的一般资料、临床资料、辅助检查结果、治疗方案及转归情况。采用多因素logistic回归分析评估肺结节病患者气道受累的相关因素。结果气道受累组出现呼吸道症状、咳嗽、气短或喘息、肺外受累、胸外淋巴结受累、ScaddingⅡ期、病理取材确诊部位为支气管黏膜、胸部高分辨率CT(HRCT)检查表现为纵隔/肺门淋巴结肿大、支气管壁增厚/狭窄、接受全身糖皮质激素治疗患者比例及中性粒细胞计数、中性粒细胞计数/淋巴细胞计数(NLR)、球蛋白水平均高于非气道受累组,ScaddingⅢ期、病理取材确诊部位为肺患者比例及淋巴细胞计数、第1秒用力呼气容积占预计值的百分比(FEV1%pred)均低于非气道受累组(P<0.05)。多因素logistic回归分析结果显示,咳嗽、中性粒细胞计数升高及胸部HRCT检查表现为支气管壁增厚/狭窄均与肺结节病患者气道受累相关(P<0.05)。结论气道受累的肺结节病患者更易出现呼吸道症状,肺结节病患者中性粒细胞计数升高、胸部HRCT检查表现为支气管壁增厚/狭窄提示可能出现气道受累。Objective To explore the clinical characteristics and related factors of airway involvement in pulmonary sarcoidosis.Methods A total of 126 patients with pulmonary sarcoidosis were divided into airway involvement group(69 cases)and non-airway involvement group(57 cases)according to airway involvement or not.General data,clinical data,auxiliary examinations results,treatment plan and outcome of the two groups were compared.Multivariate logistic regression analysis was used to evaluate related factors of airway involvement in patients with pulmonary sarcoidosis.Results Propotion of patients with cough,shortness of breath or wheezing,extrapulmonary involvement,external thoracic lymph node involvement,Scadding stageⅡ,confirmed sites of histopathologic sampling taken by bronchial mucosa,mediastinal/hilar lymph node enlargement,bronchial wall thickening/narrowing in chest high resolution CT(HRCT)examination,receiving systemic glucocorticoid therapy and neutrophil count,neutrophil count/lymphocyte count(NLR),globulin level in airway involvement group were higher than those in non-airway involvement group,propotion of patients with Scadding stageⅢ,confirmed sites of histopathologic sampling taken by lung and lymphocyte count,percentage of forced expiratory volume at the first second to predicted value(FEV1%pred)were lower than those in non-airway involvement group(P<0.05).Multivariate logistic regression analysis showed that cough,elevated neutrophil count and bronchial wall thickening/narrowing in chest HRCT examination were all related with airway involvement in patients with pulmonary sarcoidosis(P<0.05).Conclusion Patients with pulmonary sarcoidosis involving airway are more likely to develop respiratory symptoms,elevated neutrophil count and bronchial wall thickening/narrowing in chest HRCT examination were suggested possible airway involvement.

关 键 词：肺结节病 气道受累 症状 中性粒细胞 影像学 

分 类 号：R563.9[医药卫生—呼吸系统]