Piirilä P, Lehtola H, Zitting A, Kivisaari L, Koskinen H, Luukkonen R, Salo S P, Vehmas T, Nordman H, Sovijärvi A R
Dept of Occupational Diseases, Finnish Institute of Occupational Health, Helsinki.
Eur Respir J. 2000 Nov;16(5):901-8. doi: 10.1183/09031936.00.16590100.
The aim of the study was to compare the lung sounds in patients with asbestos related pulmonary disorders with findings in high-resolution computed tomography (HRCT), and with lung function variables, in order to find out associations of acoustic changes with radiological fibrosis, emphysema or with pulmonary gas transfer functions. Sixty-four patients with asbestos-related pleural disease, with or without pulmonary disease, were studied. Lung sound recording and analysis was carried out with a computerized lung sound analyser, and HRCT of the chest, as well as forced spirometry and diffusing capacity measurement were performed. The fibrosis score correlated positively with the quartile frequencies of the power spectrum of lung sounds in inspiration (f50) and expiration (f50) and crackle count in inspiration, as well as negatively with diffusing capacity. When the patients with crackling sounds and significant fibrosis were excluded (n=18), emphysema correlated negatively with expiratory quartile frequencies of the power spectrum, with f25 and f50. Furthermore, diffusing capacity correlated with inspiratory f25 and forced expiratory volume in one second with inspiratory f50 when crackles and fibrosis were excluded. Changes in lung sounds were significantly associated with radiologically verified abnormalities and gas transfer of pulmonary tissue. High sound frequencies were associated with fibrotic changes of the lung while low sound frequencies with pulmonary emphysema. Acoustic analysis gives complementary clinical information for evaluation of asbestos-related pulmonary disorders.
本研究旨在比较石棉相关肺部疾病患者的肺音与高分辨率计算机断层扫描(HRCT)结果以及肺功能变量,以找出声学变化与放射性纤维化、肺气肿或肺气体交换功能之间的关联。对64例患有或未患有肺部疾病的石棉相关胸膜疾病患者进行了研究。使用计算机化肺音分析仪进行肺音记录和分析,并进行胸部HRCT、用力肺活量测定和弥散功能测量。纤维化评分与吸气(f50)和呼气(f50)时肺音功率谱的四分位频率以及吸气时的爆裂音计数呈正相关,与弥散功能呈负相关。当排除有爆裂音和显著纤维化的患者(n = 18)后,肺气肿与功率谱的呼气四分位频率、f25和f50呈负相关。此外,当排除爆裂音和纤维化时,弥散功能与吸气f25以及一秒用力呼气容积与吸气f50相关。肺音变化与经放射学证实的异常以及肺组织的气体交换显著相关。高音频率与肺部纤维化改变相关,而低音频率与肺气肿相关。声学分析为评估石棉相关肺部疾病提供了补充临床信息。