摘要
目的探讨定量CT对肺泡蛋白沉着症(PAP)患者支气管肺泡灌洗手术(BAL)前后的应用价值。方法回顾性选取2012年1月至2017年1月间在衡水市第四人民医院和衡水市第五人民医院接受治疗且经过病理确诊为PAP患者150例,患者均经BAL治疗,CT检查资料完整;使用定量CT检测患者像素指数直方图、肺部气体总容积、肺部平均密度数值、肺部总质量和平均CT数值,使用肺功能检测仪检测患者用力肺活量(FVC)、第1秒用力呼气量(FEV1)和第1秒用力呼气量所占预计数值比率(FEV1%),计算一氧化碳弥散数量和弥散系数。并比较手术前后差异。结果患者经过灌洗手术以后肺部气体总容积有所升高,但手术前后对比差异无统计学意义(P>0.05),患者肺部平均密度、肺部CT数值和双肺总质量均明显下降,与手术前对比差异有统计学意义(P<0.05);一氧化碳弥散数量和弥散系数均明显上升,与手术前对比差异有统计学意义(P<0.05),患者FVC、FEV1和FEV1%比手术前略有好转,但差异无统计学意义(P>0.05)。结论定量CT分析PAP患者灌洗前后像素指数直方图、肺部总质量、肺部气体总容积、肺部平均CT数值和密度数值显示,定量CT能够敏感、全面和客观地评估PAP患者支气管肺泡灌洗手术的治疗效果。
Objective To explore the significance of quantitative CTscanning in diagnosis and treatment of patients with pulmonary alveolar proteinosis（ PAP） by pulmonary bronchoalveolar lavage（ BAL）. Methods A total of 150 patients with PAP confirmed by pathological diagnosis during January 2012 to January 2017 in these 2 hospitals were treated by BAL,their data of CT scanning and numerical quantitative detection of CT histogram were complete,pixel index in patients with lung gas volume,total value,the average density of total lung mass and mean CT value,the quality of pulmonary function detection in patients with FVC（ FVC）,forced expiratory volume（ FEV1） and FEV1% predicted percentage（ FEV1%）,and the difference between before and after surgery had been compared. Results The total volume of pulmonary gas in these patients after lung lavage had been increased after surgery,but there was no significant difference between before and after surgery（ P 〉 0. 05）,the total mass density,average value of CT scanning in these patients and the total quality of lungs were significantly decreased,and the difference in preoperative contrast was statistically significant（ P 〈 0. 05）. The coefficient of dispersion and dispersion of the volume of carbon monoxide were significantly increased,with significant difference with that before operation（ P 〈 0. 05）,FVC,FEV1 and FEV1% were slightly improved than before,but the difference was not significant（ P 〉 0. 05）. Conclusion Quantitative CT analysis of patients with PAP before and after lavage,total lung quality index of pixel histogram,total volume of pulmonary gas,average value of CT scannings and numerical display of lung density and quantitative CT scanning are sensitive,comprehensive and objective assessment of patients with PAP treated by bronchoalveolar lavage.
出处
《临床和实验医学杂志》
2017年第22期2273-2275,共3页
Journal of Clinical and Experimental Medicine
基金
河北省衡水市桃城区科技局项目(项目编号:20170140026Z)
