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胸部高分辨率 CT(HRCT)中空气潴留程度与心肺运动试验参数的相关性:HRCT 能否预测疾病严重程度?

Correlation between the degree of air trapping in chest HRCT and cardiopulmonary exercise test parameters: could HRCT be a predictor of disease severity?

机构信息

Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

Arch Iran Med. 2011 Mar;14(2):86-90.

PMID:21361713
Abstract

OBJECTIVE

The purpose of this study was to examine whether the degree of air trapping in high resolution computed tomography (HRCT) of patients with histories of sulfur mustard gas exposure during suspended full expiration correlated with various parameters of the cardiopulmonary exercise test as the gold standard for assessment of pulmonary function.

METHODS

In this analytic study 75 male patients, each with a history of sulfur mustard gas exposure, were investigated. Each participant underwent an incremental cardiopulmonary exercise test, pulmonary function test and arterial oxygen saturation for hemoglobin measurement. For HRCT examination, both lungs were divided into three parts (upper, middle, and lower) and in each part images were separately observed from the involved area point of view (<25% ≤6/24; >25% ≥6/24).

RESULTS

A total of 49.3% of the patients (37/75) had evidence of air trapping in over 25% of their lung segments. The mean age±SD in the patients with air trapping of =25% or <25% were 41.1±6.8 and 39.7±4.0 years, respectively (P=0.281). In our study there was no significant difference in pulmonary function test findings (FEV1, FVC and FEV1/FVC) between the two groups. There was no significant correlation with air trapping of =25% and any of the exercise test parameters. Also, no correlation was found between significant air trapping and exercise test findings in maximum exercise and anaerobic situations.

CONCLUSIONS

No correlation was found between HRCT and cardiopulmonary exercise test findings. HRCT is neither pathognomic of the disease nor a good predictor of disease severity but it might be suggestive of mustard lung injuries.

摘要

目的

本研究旨在探讨在高分辨率 CT(HRCT)上观察到的呼气末暂停时芥子气暴露史患者的空气潴留程度与心肺运动试验(作为评估肺功能的金标准)的各种参数之间是否存在相关性。

方法

在这项分析性研究中,共调查了 75 名有芥子气暴露史的男性患者。每位患者均接受了递增心肺运动试验、肺功能测试和动脉血氧饱和度血红蛋白测量。对于 HRCT 检查,将双肺分为三个部分(上、中、下),并从受累区域的角度分别观察每个部分的图像(<25% ≤6/24;>25% ≥6/24)。

结果

共有 49.3%(37/75)的患者在超过 25%的肺段中存在空气潴留的证据。空气潴留≥25%和<25%的患者的平均年龄±标准差分别为 41.1±6.8 和 39.7±4.0 岁(P=0.281)。在我们的研究中,两组之间的肺功能测试结果(FEV1、FVC 和 FEV1/FVC)没有显著差异。空气潴留≥25%与运动试验的任何参数之间均无显著相关性。同样,在最大运动和无氧情况下,明显的空气潴留与运动试验结果之间也没有相关性。

结论

HRCT 与心肺运动试验结果之间没有相关性。HRCT 既不是疾病的特征性表现,也不能很好地预测疾病的严重程度,但它可能提示存在芥子气肺损伤。

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