摘要
目的探讨慢性阻塞性肺疾病（COPD）合并肺纤维化的临床特点及意义，提高对疾病的认识和诊断水平。方法选择45例COPD合并肺纤维化患者及30例COPD患者为研究对象，回顾性分析2组患者的一般临床资料、肺功能、血气分析、胸部高分辨率CT（HRCT）表现，随访1年内COPD急性加重次数。结果与COPD组相比，COPD合并肺纤维化组患者肺功能改变以混合性通气功能障碍为主，弥散功能较COPD组降低更为显著，低氧血症更为明显，而二氧化碳潴留则不如单纯COPD患者严重。COPD合并肺纤维化患者的HRCT表现兼有肺气肿和肺纤维化的影像学特点，1年内急性加重频率高于单纯COPD组。结论当COPD和肺纤维化并存时，其肺功能、血气分析、HRCT表现具有与单纯COPD不同的特点，且更易发生COPD急性加重。
Objective To study the clinical characteristics and clinical significance of chronic obstructive pulmonary disease（COPD） with pulmonary fibrosis in order to improve the diagnostic ability. Methods 45 patients with coexistent COPD and pulmonary fibrosis and 30 patients with COPD were enrolled in the retrospective study. Clinical characteristics were compared between the two groups , including general clinical data, high resolution computed tomography （HRCT）, pulmonary function test, blood -gas analysis and the frequency times of acute exacerbation of COPD at 1 year follow - up. Result The pulmonary function tests showed that most patients with coexistent COPD and pulmonary fibrosis had mixed ventilation disturbances. The reduction in diffusing capacity in patients with coexistent COPD and pulmonary fibro- sis was more significant compared with patients with COPD. The COPD with pulmonary fibrosis group showed lower hy- poxemia but not higher hypercapnia compared with COPD group. The HRCT findings in patients with COPD coupled with pulmonary fibrosis showed the characteristics of both pulmonary emphysema and pulmonary fibrosis. Patients with coexist- ent COPD and pulmonary fibrosis had significantly higher exacerbation rate in the 1 - year follow - up period compared with patients with COPD alone. Conclusion COPD and pulmonary fibrosis coexist in some patients, the presentations of HRCT, pulmonary function test and blood -gas analysis are markedly different from patients with COPD alone. Further- more, patients with coexistent COPD and pulmonary fibrosis have more frequent COPD exacerbations compared with pa- tients with COPD alone.
出处
《徐州医学院学报》
CAS
2013年第3期187-190,共4页
Acta Academiae Medicinae Xuzhou
关键词
慢性阻塞性肺疾病
肺纤维化
肺功能
高分辨率CT
chronic obstructive pulmonary disease
pulmonary fibrosis
lung function test
high resolution compu- ted tomography
