重度肺老化HRCT诊断与相关危险因素分析.docVIP

重度肺老化HRCT诊断与相关危险因素分析 　　【摘要】 目的：评价重度肺老化在高分辨率CT（HRCT）上的影像表现及与临床危险因素之间的相关性。方法：搜集具有完整病史且经HRCT诊断为重度肺老化的患者60例和无肺老化患者56例进行研究。选择相关危险因素进行每个单因素Logistic回归分析，再将有统计学意义的因素，纳入多因素回归分析确定与重度肺老化相关的独立危险因素。结果：重度肺老化在HRCT上主要表现为肺气肿、肺间质性改变、肺内空气潴留等征象。高年龄、慢性支气管炎、过敏病史、吸烟、粉尘、冠心病、高血压是重度肺老化发生的危险因素，是纳入多因素logistic回归分析的有统计学意义的变量。结论：HRCT可作为肺老化检查和分度的首选检查方法；年龄≥70岁、慢性支气管炎、吸烟、粉尘、高血压病是肺老化的独立发病危险因素。 　　【关键词】 肺老化； 危险因素； 高分辨CT 　　【Abstract】 Objective： To evaluate the sign of severe lung aging by HRCT and related risk factors to predict the value of illness.Method：115 hospitalized patients examined lung HRCT were screened out with collecting whole clinical date. Among them there are 56 patients without lung aging （non- lung aging） and 60 patients with severe lung aging. Single and multi-logistic regression analyses were used to assess the relationship between severe lung aging and risk factors. Result： The severe lung aging features of HRCT are Emphysema pulmonum， interstitial lung changes， air trapping and so on. Single factor Logistic regression analysis was used to assess the correlation severe lung aging with the non- lung aging， and significant risk factors were entered into the multi-factors Logistic regression analysis. The factors with a statistically significant difference were independent risk factors associated with lung aging. They were age， gender， chronic bronchitis， allergy， smoking， dust exposure， coronary disease， hypertension. Conclusion：HRCT may be the first choice for the diagnosis of lung aging. The age ≥70 years， chronic bronchitis， smoking， dust exposure， hypertension were independent risk factors for severe lung aging. 　　【Key words】 Lung aging； Risk factors； HRCT 　　肺老化（lung aging）是指随年龄增长肺功能和形态出现的退行性改变。已经明确的是，即使在健康老年人群，其肺功能也是随着年龄的增长而退化的[1]。肺部具有良好的天然对比度，HRCT的广泛应用更为肺部细微结构的研究提供了广阔空间。本研究旨在应用HRCT影像学技术探讨肺老化的影像表现及其与危险因素之间的相关性。 　　1 资料与方法 　　1.1 一般资料 本研究选取2013年9月-2014年3月在本院行肺部HRCT检查的住院患者，筛选出其中有完整临床资料的116例患者，男67例，女49例，年龄48～93岁，平均（68.9±11.0）岁，所选患者基本未出现呼吸道症状，仅少数患者偶有咳嗽。其中无肺老化患者56例，男女各28例，年龄45～8