Yorgancioğlu Arzu, Sakar Ayşin, Tarhan Serdar, Celik Pinar, Göktan Cihan
Celal Bayar University Faculty of Medicine, Pulmonary Diseases, Manisa, Turkey.
Tuberk Toraks. 2003;51(1):5-10.
Recent studies suggest that thoracal high resolution computed tomography (HRCT) of the thorax can detect the irreversible structural changes in chronic asthma cases. This study is aimed to evaluate these possible changes and their relation with asthma severity. Twenty-eight stable asthmatic patients with normal conventional radiography and 10 healthy controls were included. Twenty of the patients were female (71.4%) and the mean age of the group was 43 +/- 10.5 (30-61). The groups were divided into 2; as group 1 included mild intermittent and mild persistent cases, and group 2 included moderate and severe persistent cases. Asthma and control group, and group 1 and 2 were compared according to the thickness of airwall (T), thickness to outer diameter (T/D), wall area (WA), the percentage wall area (WA%). HRCT showed that air trapping, bronchiectasis, fibrotic lesions and airwall thickening were significantly more common in asthma group (p< 0.05). Emphysema, acinar pattern, collapse and mucoid impact were common in asthma group (p> 0.05). The incidence of T and WA was higher in asthma group but also did not reach statistical significance and the thickening of airwall in small airways was significantly more in asthma group. Any correlation between HRCT findings and asthma severity was not found. So reversible and irreversible bronchial and parenchymal changes, detected by HRCT but not by plain chest radiograms, may be present in asthma cases. The early detection of these changes may lead more aggressive asthma management.
近期研究表明,胸部高分辨率计算机断层扫描(HRCT)能够检测出慢性哮喘病例中不可逆的结构变化。本研究旨在评估这些可能的变化及其与哮喘严重程度的关系。纳入了28例常规放射检查正常的稳定期哮喘患者和10名健康对照者。患者中20例为女性(71.4%),该组平均年龄为43±10.5岁(30 - 61岁)。将这些组分为两组;第1组包括轻度间歇性和轻度持续性病例,第2组包括中度和重度持续性病例。根据气道壁厚度(T)、厚度与外径之比(T/D)、气道壁面积(WA)、气道壁面积百分比(WA%),对哮喘组与对照组以及第1组和第2组进行比较。HRCT显示,哮喘组中气体潴留、支气管扩张、纤维化病变和气壁增厚更为常见(p<0.05)。肺气肿、腺泡样改变、肺不张和黏液嵌塞在哮喘组也较为常见(p>0.05)。哮喘组T和WA的发生率较高,但未达到统计学意义,且哮喘组小气道气壁增厚更为明显。未发现HRCT结果与哮喘严重程度之间存在任何相关性。因此,HRCT检测到但胸部平片未检测到的可逆性和不可逆性支气管及实质改变可能存在于哮喘病例中。这些变化的早期检测可能会带来更积极的哮喘管理。