哮喘患者与健康吸烟者肺部HRCT扫描对比研究_临床医学论文.docVIP

哮喘患者与健康吸烟者肺部HRCT扫描对比研究_临床医学论文 哮喘患者与健康吸烟者肺部HRCT扫描对比研究_临床医学论文 作者：阎玉明 闫如虎 张兰慧 【摘要】 目的 初步探讨哮喘患者、健康吸烟者及正常无吸烟志愿者肺部HRCT扫描中空气潴留的分布情况及呼气、吸气末肺容积之比。方法 对30例哮喘患者，15例健康吸烟者及15例正常无吸烟者行肺部吸气末及呼气末HRCT扫描，并行肺功能检查，重点观察呼气末空气潴留象、呼气末与吸气末肺容积之比。 结果 哮喘组、健康吸烟组、无吸烟组所观察到空气潴留个数分别为12.5±3.2、3.5±0.6、3.2±0.7，呼气末肺容积与吸气末肺容积之比分别为0.67±0.21、0.58±0.12、0.56±0.10，两组数据哮喘组与健康吸烟组及无吸烟组比较皆具有统计学差异，健康吸烟组与无吸烟组比较统计学上无显著性差异。 结论 空气潴留在哮喘患者及健康人肺部HRCT中皆有出现，但在哮喘患者肺部出现频度较高，健康吸烟者与健康无吸烟者两组肺功能皆正常，空气潴留出现频度较低。 【关键词】 高分辨率; 计算机断层　扫描; 空气潴留; 哮喘; 吸烟 [Abstract] Objective To evaluate lung function and lung volume in patients suffering from asthma, with special attention to air trapping on CT in comparison with that detected in smoking and non-smoking normal subjects. Methods Thirty patients with asthma and control subjects including healthy volunteers, smokers (n=15) and non-smokers (n=15) were explored by high-resolution CT (HRCT) performed at suspended full inspiration and expiration.All subjects underwent pulmonary function tests and air trapping of lung were counted, rate of lung volume of expiration and inspiration were calculated. Results Air trapping scores were got in three groups, they were 12.5±3.2,3.5±0.6,3.2±0.7, rate of lung volume of expiration and inspiration in three groups were 0.67±0.21,0.58±0.12,0.56±0.10, the asthma patients and control subjects had statistical distinct difference (plt;0.05), the smoking group and the non-smoking group had no statistical distinct difference (pgt;0.05). Conclusion Air trapping scores are higher in asthmatic patients than in smoking and non-smoking control subjects, but smoking control subjects and non-smoking subjects have no difference. 　　[Key words] high-resolution; computed tomography; air trapping; asthma; smoking 　　吸气末联合呼气末肺部HRCT扫描已广泛运用于肺部各种病变研究，其中包括肺气肿、哮喘、弥漫性肺部疾病、结缔组织性疾病及小气道病变，众多征像中如网格影、小结节影、磨玻璃影等，空气潴留影更适用于小气道病变的研究，空气潴留在病理上是指在呼气过程的任何阶段过多的气体滞留在全部或部分肺组织内，在影像中主要通过呼气末肺部HRCT中异常的低密度区表现出来。以往研究多针对肺部疾病在HRCT中的表现，本研究初步探讨哮喘患者、健康吸烟者及正常无吸烟志愿者肺部HRCT中空气潴留的分布情况，及吸气末与呼气末肺容积改变。 　　材料与方法 　　1.病例组与对照