不同吸烟量无症状肺小气道损害患者HRCT特点及识别  

HRCT characteristics and identification of asymptomatic pulmonary small airway damage in patients with different smoking levels

作　　者：李杜 谢永健 崔文民 谢晓丹 肖智 LI Du;XIE Yongjian;CUI Wenmin;XIE Xiaodan;XIAO Zhi(Department of Radiology,Nanhai Hospital,Guangdong Provincial People's Hospital,Foshan,Guangdong 528200,China)

机构地区：[1]广东省人民医院南海医院放射科,广东佛山528200

出　　处：《影像研究与医学应用》2024年第12期12-14,共3页Journal of Imaging Research and Medical Applications

基　　金：广东省佛山市科技计划项目(2018AB001612)。

摘　　要：目的:探讨不同吸烟量无症状肺小气道损害患者高分辨率CT(HRCT)特点。方法:选取2022年3月—2023年12月广东省人民医院南海医院收治的肺小气道损害患者166例,按照是否吸烟将患者分为非吸烟组(59例)和吸烟组(107例),吸烟组根据吸烟量分为低吸烟量组(51例,每日吸烟<5支)与高吸烟量组(56例,每日吸烟≥5支)。所有患者均进行吸气末和呼气末HRCT扫描,分析患者HRCT结果。结果:吸烟组患者吸气相肺容积、呼气相肺容积、吸气相低衰减区比例、呼气相低衰减区比例均高于非吸烟组患者,高吸烟量组吸气相肺容积、呼气相肺容积、吸气相低衰减区比例、呼气相低衰减区比例均高于低吸烟量组,差异有统计学意义(P<0.05)。高吸烟量组患者小叶中心型肺气肿、全小叶型肺气肿、胸膜结节、空气潴留等发生率均高于低吸烟量组和非吸烟组,小叶中心气腔结节、亚段肺不张发生率高于非吸烟组,且低吸烟量组小叶中心型肺气肿、全小叶型肺气肿、胸膜结节、空气潴留、小叶中心气腔结节等发生率高于非吸烟组,差异均有统计学意义(P<0.05)。结论:吸烟的无症状肺小气道损害患者HRCT扫描显示存在肺容积参数改变和肺部病变,且大量吸烟患者肺部病变表现更为严重。Objective To explore the characteristics of high-resolution CT(HRCT)in asymptomatic small airway damage patients with different smoking levels.Methods 166 patients with pulmonary small airway damage admitted to our hospital from March 2022 to December 2023 were selected and divided into a non-smoking group(59 cases)and a smoking group(107 cases)based on whether they smoked.The smoking group was divided into low smoking group(51 cases,smoking<5 cigarettes per day)and high smoking group(56 cases,smoking≥5 cigarettes per day)based on smoking volume.All patients underwent end inspiratory and end expiratory HRCT scans,and the HRCT results were analyzed.Results The smoking group had higher inspiratory lung volume,expiratory lung volume,proportion of low attenuation areas in the inspiratory phase,and proportion of low attenuation areas in the expiratory phase compared to non-smoking group patients.The high smoking group had significantly higher inspiratory lung volume,expiratory lung volume,proportion of low attenuation areas in the inspiratory phase,and proportion of low attenuation areas in the exhalatory phase compared to the low smoking group,the differences were statistically significant(P<0.05).The incidence of lobular central emphysema,total lobular emphysema,pleural nodules and air trapping in the high smoking group were higher than those in the low smoking group and the non-smoking group.The incidence of lobular central air cavity nodules and subsegmental atelectasis in the high smoking group was higher than that in the non-smoking group.The incidence of centrilobular emphysema,total lobular emphysema,pleural nodules,air trapping,and centrilobular air nodules in the low smoking group was higher than that in the non-smoking group,the differences were statistically significant(P<0.05).Conclusion HRCT scans of asymptomatic pulmonary small airway damage patients who smoke show changes in lung volume parameters and lung lesions,and a large number of smoking patients have more severe lung lesions.

关 键 词：肺小气道损害 高分辨率CT 吸烟 肺容积参数 

分 类 号：R445.3[医药卫生—影像医学与核医学]