Fazzi P, Sbragia P, Solfanelli S, Troilo S, Giuntini C
Cardiac and Thoracic Department, Respiratory Pathophysiology Section, University of Pisa, Italy.
Chest. 2001 Apr;119(4):1270-4. doi: 10.1378/chest.119.4.1270.
We describe four patients with proven sarcoidosis and minor pulmonary involvement according to high-resolution CT (HRCT) findings in whom the recently described sign of decreased attenuation on expiratory HRCT scan appeared associated with the reduction of the single-breath diffusing capacity of the lung for carbon monoxide (DLCO) and the DLCO adjusted for alveolar volume. These alterations were, in part, reversible under steroid treatment. Major indexes of airway obstruction (FEV(1)/vital capacity ratio and FEV(1)) were normal, while the maximum expiratory flow at 25% above the residual volume of FVC was reduced. These observations suggest that an expiratory HRCT mosaic pattern and diffusion impairment may be early findings in pulmonary sarcoidosis and may be useful for its detection and follow-up.
我们描述了4例经证实患有结节病且根据高分辨率CT（HRCT）表现为轻度肺部受累的患者，在这些患者中，最近描述的呼气HRCT扫描上衰减降低的征象似乎与肺一氧化碳单次呼吸弥散量（DLCO）及经肺泡容积校正的DLCO降低有关。这些改变部分在类固醇治疗下是可逆的。气道阻塞的主要指标（FEV₁/肺活量比值和FEV₁）正常，而在FVC残气量之上25%时的最大呼气流量降低。这些观察结果表明，呼气HRCT的马赛克样表现和弥散功能障碍可能是肺结节病的早期表现，可能有助于其检测和随访。
