Morrison N J, Abboud R T, Müller N L, Miller R R, Gibson N N, Nelems B, Evans K G
Department of Radiology, University of British Columbia, Vancouver General Hospital, Canada.
Am Rev Respir Dis. 1990 Jan;141(1):53-61. doi: 10.1164/ajrccm/141.1.53.
We determined single breath diffusing capacity (DLCO) and pulmonary capillary blood volume (Vc) in a total of 110 patients, who were being evaluated for resectional lung surgery for a localized tumor or lesion. Pathologic assessment of emphysema was obtained in 55 cases who had resection of a lung or an upper lobe, based on a standard reference panel for emphysema grading. In 86 cases, the extent of emphysema was quantitated by computed tomography (CT) of the chest. There was a significant negative correlation between Vc and emphysema assessed by either pathology or CT (r = about -0.5, p less than 0.001) similar to the correlation between DLCO and the extent of emphysema. Results of Vc were significantly lower in cases with moderate emphysema (pathologic grade greater than or equal to 30) than those with no emphysema (grade less than or equal to 5) (p less than 0.001) or mild emphysema (grade 10 to 25) (p less than 0.05), and they were significantly lower (p less than 0.05) in the group with mild emphysema compared with the group with no emphysema on pathologic assessment similar to DLCO results. Although Vc was reduced in emphysema, determination of Vc did not result in improved discrimination in separating cases with emphysema from those without emphysema when compared with DLCO.
我们对总共110例因局限性肿瘤或病变而接受肺切除手术评估的患者测定了单次呼吸弥散容量（DLCO）和肺毛细血管血容量（Vc）。基于肺气肿分级的标准参考面板，对55例行肺或上叶切除的病例进行了肺气肿的病理评估。在86例病例中，通过胸部计算机断层扫描（CT）对肺气肿程度进行了定量分析。Vc与通过病理或CT评估的肺气肿之间存在显著的负相关（r约为 -0.5，p小于0.001），这与DLCO和肺气肿程度之间的相关性相似。中度肺气肿（病理分级大于或等于30）病例的Vc结果显著低于无肺气肿（分级小于或等于5）或轻度肺气肿（分级10至25）的病例（p小于0.001），并且在病理评估中，轻度肺气肿组的Vc结果与无肺气肿组相比也显著降低（p小于0.05），这与DLCO结果相似。尽管肺气肿时Vc降低，但与DLCO相比，测定Vc在区分有肺气肿和无肺气肿的病例方面并未提高辨别能力。
