Warrick J H, Bhalla M, Schabel S I, Silver R M
Department of Medicine, Medical University of South Carolina, Charleston 29425.
J Rheumatol. 1991 Oct;18(10):1520-8.
Seventeen patients with early systemic sclerosis (SSc) underwent high resolution computed tomography (HRCT) of the chest to evaluate dyspnea and/or abnormal pulmonary function tests (PFT). All patients were assigned a dyspnea score and each had routine chest radiography (CXR). Bronchoalveolar lavage (BAL) was performed on 10 patients. HRCT was abnormal in 15 patients (88%), while CXR was abnormal in only 10 patients (59%). Mediastinal lymphadenopathy was detected in 7 patients (41%). Disease duration, dyspnea score, and forced vital capacity (FVC) did not correlate with HRCT score. However, trends toward higher total BAL cell counts and higher BAL neutrophil counts were noted in patients with ground glass opacities on HRCT, and BAL lymphocyte counts were significantly higher in such cases. HRCT is superior to CXR for detecting early interstitial lung disease in SSc, but patient history and FVC correlate poorly with HRCT findings. Ground glass opacities on HRCT may reflect active alveolitis, and mediastinal lymphadenopathy associated with SSc lung disease may be a consequence of pulmonary inflammation.
17例早期系统性硬化症（SSc）患者接受了胸部高分辨率计算机断层扫描（HRCT），以评估呼吸困难和/或异常的肺功能测试（PFT）。所有患者均被赋予呼吸困难评分，且均进行了常规胸部X线摄影（CXR）。对10例患者进行了支气管肺泡灌洗（BAL）。15例患者（88%）的HRCT异常，而仅10例患者（59%）的CXR异常。7例患者（41%）检测到纵隔淋巴结肿大。病程、呼吸困难评分和用力肺活量（FVC）与HRCT评分无关。然而，HRCT上有磨玻璃影的患者BAL细胞总数和BAL中性粒细胞计数有升高趋势，且此类病例的BAL淋巴细胞计数显著更高。在检测SSc早期间质性肺疾病方面，HRCT优于CXR，但患者病史和FVC与HRCT结果的相关性较差。HRCT上的磨玻璃影可能反映活动性肺泡炎，与SSc肺部疾病相关的纵隔淋巴结肿大可能是肺部炎症的结果。
