Lee Eun Joo, Lee Sang Yeub, In Kwang Ho, Yoo Se Hwa, Choi Eun Jeong, Oh Yu Whan, Park Sanghoon
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 136-705, Republic of Korea.
ScientificWorldJournal. 2012;2012:835031. doi: 10.1100/2012/835031. Epub 2012 May 1.
Tuberculous destroyed lung (TDL) is diagnosed by a clear past history of tuberculosis with findings of parenchymal destruction verified by chest X-ray. Despite the resultant deterioration of lung function and quality of lives seen in TDL patients, the exact mechanism or characteristics of pulmonary function worsening have not been clearly studied. We investigated the feature of respiratory impairment of TDL patients, and studied whether extent of destroyed lung measured with chest CT has any correlation with routine lung function. To evaluate the degree of destruction, the Goddard classification scoring system was modified into a novel scoring system (destroyed lung score, (DLS)) with a score from 0 to 4. Twenty-five subjects were enrolled. TDL predominantly manifested as an obstructive pattern (64%, 16/25). Median value of DLS of the entire lung was 2.6 (1.7-3.9). Absolute values of FEV1 and FVC were both negatively associated with DLS (r = -0.78, P = 0.001, and r = -0.61, P = 0.021). Percentage of predicted value of FEV₁ and FVC were also negatively associated with DLS (r = -0.62, P = 0.019, and r = -0.76, P = 0.002). Our study shows that lung function of TDL patients were notably correlated with the extent of destroyed lung measured with chest CT scan.
结核毁损肺（TDL）通过明确的结核病史及胸部X线证实的实质破坏表现来诊断。尽管TDL患者会出现肺功能和生活质量下降，但肺功能恶化的确切机制或特征尚未得到明确研究。我们调查了TDL患者呼吸功能损害的特征，并研究了胸部CT测量的肺毁损程度与常规肺功能之间是否存在关联。为评估破坏程度，将戈达德分类评分系统修改为一种新的评分系统（肺毁损评分，（DLS）），评分范围为0至4分。共纳入25名受试者。TDL主要表现为阻塞性模式（64%，16/25）。全肺DLS的中位数为2.6（1.7 - 3.9）。FEV1和FVC的绝对值均与DLS呈负相关（r = -0.78，P = 0.001，r = -0.61，P = 0.021）。FEV₁和FVC预测值百分比也与DLS呈负相关（r = -0.62，P = 0.019，r = -0.76，P = 0.002）。我们的研究表明，TDL患者的肺功能与胸部CT扫描测量的肺毁损程度显著相关。
