Amjadi Kayvan, Alvarez Gonzalo G, Vanderhelst Eef, Velkeniers Brigitte, Lam Miu, Noppen Marc
University of Ottawa, Ottawa Hospital, (Civic Campus), Division of Respirology, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9.
Chest. 2007 Oct;132(4):1140-5. doi: 10.1378/chest.07-0029. Epub 2007 Sep 21.
To determine the prevalence of blebs or bullae using thoracoscopy in young healthy adults, and to compare patient characteristics among those with and without blebs.
Bilateral thoracoscopic evaluation of the lungs was performed in healthy individuals who were referred for thoracoscopic thoracic sympathectomy for essential hyperhidrosis. Participants were enrolled into a registry and followed for up to 9 years.
Analysis was performed on 250 consecutive cases. Blebs were observed in 15 of 250 individuals (6%; male, n = 6; female, n = 9; mean age, 25.3 years; range, 15 to 51 years). Individuals with blebs had a significantly lower body mass index (BMI) [mean +/- SD, 20.7 +/- 2.4 kg/m(2) vs 22.7 +/- 3.4 kg/m(2); p = 0.027] when compared to individuals without blebs, whereas all other parameters were similar. Blebs were most prevalent among slim individuals (BMI < 22 kg/m(2)) who smoked (odds ratio, 5.9; 95% confidence interval, 1.19 to 29.20).
Blebs were identified thoracoscopically in 6% of young healthy adults with no underlying lung disease. Low BMI in combination with smoking may have an important role in the development of pleural blebs in healthy young adults; however, these changes may not be responsible for future spontaneous pneumothoraces.
通过胸腔镜检查确定年轻健康成年人中肺大疱或疱状突起的患病率，并比较有和无肺大疱者的患者特征。
对因原发性多汗症接受胸腔镜胸交感神经切除术而转诊的健康个体进行双侧肺胸腔镜评估。参与者被纳入登记系统并随访长达9年。
对250例连续病例进行分析。250名个体中有15名观察到肺大疱（6%；男性6例，女性9例；平均年龄25.3岁；范围15至51岁）。与无肺大疱者相比，有肺大疱者的体重指数（BMI）显著更低[平均±标准差，20.7±2.4kg/m²对22.7±3.4kg/m²；p=0.027]，而所有其他参数相似。肺大疱在吸烟的消瘦个体（BMI<22kg/m²）中最为普遍（比值比，5.9；95%置信区间，1.19至29.20）。
在无潜在肺部疾病的年轻健康成年人中，通过胸腔镜检查发现6%存在肺大疱。低BMI与吸烟相结合可能在健康年轻成年人胸膜肺大疱的形成中起重要作用；然而，这些改变可能与未来的自发性气胸无关。
