Stratelis Georgios, Fransson Sven-Göran, Schmekel Birgitta, Jakobsson Per, Mölstad Sigvard
Primary Care Centre, Vårdcentralen Brinken, Motala, Sweden.
Scand J Prim Health Care. 2008;26(4):241-7. doi: 10.1080/02813430802452732.
To evaluate to what extent emphysema was evident, as identified by High Resolution Computed Tomography (HRCT), in smokers with normal lung function and to relate age, gender, smoking history, and body mass index (BMI) to the HRCT results. A secondary aim was to study to what extent emphysema was present in smokers with lower normal values of lung function defined as FEV(1)/FVC ratio percentage of predicted value (89-93% of predicted value for males and 90-93% for females) or FEF(50) < or = 60% of predicted compared with smokers without this definition.
Fifty-nine smokers, with a mean age of 53 years and with normal lung function, were examined with HRCT.
Emphysema evidenced visually by HRCT was present in 43% of the subjects. Using a 0-5 grade scale (0=normal finding; 5=emphysema in most slices), the degree of emphysema was almost exclusively 3-4. The type of emphysema was distributed as centrilobular emphysema predominant in 43.5%, paraseptal emphysema predominant in 43.5%, and as an equal mixture of these types in 13%. The presence of emphysema did not differ between the group of smokers with lower normal values of lung function and the rest of the smokers. Smokers with emphysema had significantly lower BMI than those devoid of emphysema, 24 and 27 respectively (p<0.0011).
There was a high occurrence of visual emphysema in middle-aged smokers with normal lung function. The densitometric quantitative analysis method is inadequate for detecting mild emphysema. High prevalence of emphysema was associated with low BMI.
通过高分辨率计算机断层扫描（HRCT）评估肺功能正常的吸烟者肺气肿的明显程度，并将年龄、性别、吸烟史和体重指数（BMI）与HRCT结果相关联。次要目的是研究肺功能处于较低正常范围（定义为男性FEV(1)/FVC比值百分比为预测值的89 - 93%，女性为90 - 93%，或FEF(50)≤预测值的60%）的吸烟者与未定义为此类的吸烟者相比，肺气肿的存在程度。
对59名平均年龄为53岁且肺功能正常的吸烟者进行HRCT检查。
HRCT视觉上显示有肺气肿的受试者占43%。使用0 - 5级评分量表（0 =正常表现；5 =大多数切片有肺气肿），肺气肿程度几乎均为3 - 4级。肺气肿类型分布为：以小叶中心型肺气肿为主的占43.5%，以间隔旁型肺气肿为主的占43.5%，两种类型等量混合的占13%。肺功能处于较低正常范围的吸烟者组与其他吸烟者组之间肺气肿的存在情况无差异。有肺气肿的吸烟者BMI显著低于无肺气肿者，分别为24和27（p < 0.0011）。
肺功能正常的中年吸烟者中，视觉上肺气肿的发生率较高。密度定量分析方法不足以检测轻度肺气肿。肺气肿的高患病率与低BMI相关。
