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特发性肺纤维化合并肺气肿的临床特征。

Clinical characteristics of combined pulmonary fibrosis and emphysema.

机构信息

First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

Respirology. 2010 Feb;15(2):265-71. doi: 10.1111/j.1440-1843.2009.01676.x. Epub 2009 Dec 27.

Abstract

UNLABELLED

This study describes the clinical characteristics of patients with CPFE and compares these with patients with COPD. It should therefore be noteworthy that the prevalence of lung cancer might be high in CPFE patients.

BACKGROUND AND OBJECTIVE

Patients with combined pulmonary fibrosis and emphysema (CPFE) are sometimes seen, and we speculate that these patients have some different clinical characteristics from COPD patients. This study clarifies the clinical characteristics of CPFE patients.

METHODS

This was a retrospective study of 47 stable patients with concurrent emphysema and diffuse parenchymal lung disease with fibrosis, based on the findings of chest CT (CPFE patients). The clinical characteristics of CPFE patients were compared with those of emphysema-dominant COPD patients without parenchymal lung disease (COPD patients).

RESULTS

Forty-six of the 47 CPFE patients were male. Paraseptal emphysema was particularly common in the CPFE group. Honeycombing, ground-glass opacities and reticular opacities were present in 75.6%, 62.2% and 84.4% of CPFE patients, respectively. Twenty-two of the 47 CPFE patients (46.8%) had lung cancer. Pulmonary function tests showed that the CPFE group had milder airflow limitation and lower diffusing capacity than the COPD group. Desaturation during 6-min walking test in CPFE patients tended to be more severe than in COPD patients, if the level of FEV1 or 6MWD was equal.

CONCLUSIONS

CPFE patients had some different clinical characteristics in comparison with COPD patients and may also have a high prevalence of lung cancer.

摘要

目的

本研究描述了 CPFE 患者的临床特征,并将其与 COPD 患者进行了比较。因此,CPFE 患者的肺癌患病率可能较高应该值得注意。

背景和目的

有时会见到合并肺纤维化和肺气肿的 CPFE 患者,我们推测这些患者与 COPD 患者具有一些不同的临床特征。本研究旨在阐明 CPFE 患者的临床特征。

方法

这是一项回顾性研究,纳入了 47 例胸部 CT 显示同时存在肺气肿和弥漫性实质肺疾病伴纤维化的稳定患者(CPFE 患者)。比较了 CPFE 患者的临床特征与无实质肺疾病的肺气肿为主的 COPD 患者(COPD 患者)的临床特征。

结果

47 例 CPFE 患者中,46 例为男性。间隔旁肺气肿在 CPFE 组中尤为常见。CPFE 患者中分别有 75.6%、62.2%和 84.4%存在蜂窝肺、磨玻璃影和网状影。47 例 CPFE 患者中有 22 例(46.8%)患有肺癌。肺功能检查显示 CPFE 组的气流受限程度比 COPD 组轻,弥散能力比 COPD 组低。如果 FEV1 或 6MWD 水平相等,CPFE 患者在 6 分钟步行试验中的低氧血症程度比 COPD 患者更严重。

结论

CPFE 患者与 COPD 患者相比具有一些不同的临床特征,并且肺癌的患病率也可能较高。

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