J Biol Regul Homeost Agents. 2013 Apr-Jun;27(2):579-87.
The purpose of the study was to identify the correlation between functional lung parameters to the extent of lung involvement evaluated by High Resolution Computed Tomography (HRCT) in systemic sclerosis (SSc), using a modified score scale. Forty-two patients with established clinical diagnosis of systemic sclerosis were retrospectively selected from the hospital information system and were prospectively included in the study protocol undergoing chest radiography, HRCT and functional lung testing. Lung involvement was assessed by HRCT, lesions were assessed in the individual segments and an additional severity score was introduced by assigning 3 points for bilateral lesions. The total new HRCT score was statistically related to severity of functional lung parameters. Thirty-six out of 42 patients showed an interstitial lung involvement by HRCT: Ground Glass (GG) n=36/42 of which n=27/36 were bilateral; IPM n=30/42, of which 24/30 were bilateral; SL n=33/42 of which 18/33 were bilateral; HC n=6/42 of which 6/6 were bilateral; SC n=6/42 of which 3/6 were bilateral.18/42 had a total score between 0-10, 6/42 between 11-20, 12/42 between 21-30, 6/42 greater than 31. Fifteen out of 42 had restrictive deficit. The results of functional respiratory testing were: FVC less than 80 percent in 12/42 patients (28.5 percent), TLC less than 80 percent in 15/42 patients (35.7 percent), DLCO less than 80 percent in 38/42 patients (90.4 percent) and DLCO/VA less than 80 percent in 21/42 patients (50 percent). The total score was statically related with FVC and TLC and with DLCO and DLCO/VA showing a significant negative correlation found between the total HRCT score of extent of lung damage and lung-function parameter (TLC: r= -0.65, P=0.00000264; FVC: r= -0.50; P=0.000575; DLCO: r= -0.74, P=2.02E-8; DLCO/VA: r= -0.68, P=0.0000005). All Pairwise Multiple Comparison Procedures showed a significant difference between the two rank sums that enclosed the comparison for DLCO/VA vs SCORE and DLCO vs SCORE. In conclusion, our modified score scale gives interesting additional data to evaluate the extension of interstitial lung involvement in SSc. It is inversely proportional to spirometry and DLCO and DLCO/VA. The bilateralism of the lesions is directly proportional to the lung damage.
本研究的目的是使用改良评分量表，确定功能性肺参数与系统性硬化症（SSc）中通过高分辨率计算机断层扫描（HRCT）评估的肺受累程度之间的相关性。从医院信息系统中回顾性选择 42 例临床确诊为系统性硬化症的患者，并前瞻性纳入研究方案，进行胸部 X 线摄影、HRCT 和肺功能检查。通过 HRCT 评估肺受累情况，对各个节段的病变进行评估，并引入额外的严重程度评分，为双侧病变分配 3 分。新的 HRCT 总分与功能性肺参数的严重程度具有统计学相关性。42 例患者中有 36 例 HRCT 显示间质性肺受累：磨玻璃影（GG）n=36/42，其中 n=27/36 为双侧；小叶间隔增厚（IPM）n=30/42，其中 n=24/30 为双侧；胸膜下线（SL）n=33/42，其中 n=18/33 为双侧；蜂窝影（HC）n=6/42，其中 n=6/6 为双侧；索条影（SC）n=6/42，其中 n=3/6 为双侧。18/42 例患者的总分为 0-10，6/42 例患者的总分为 11-20，12/42 例患者的总分为 21-30，6/42 例患者的总分为大于 31。42 例中有 15 例存在限制性缺陷。功能性呼吸检测结果如下：42 例患者中有 12 例（28.5%）FVC 小于 80%，15 例（35.7%）TLC 小于 80%，38 例（90.4%）DLCO 小于 80%，21 例（50%）DLCO/VA 小于 80%。总评分与 FVC 和 TLC 以及 DLCO 和 DLCO/VA 具有统计学相关性，显示肺损伤程度的总 HRCT 评分与肺功能参数（TLC：r=-0.65，P=0.00000264；FVC：r=-0.50；P=0.000575；DLCO：r=-0.74，P=2.02E-8；DLCO/VA：r=-0.68，P=0.0000005）之间存在显著负相关。所有两两多重比较程序显示，DLCO/VA 与 SCORE 和 DLCO 与 SCORE 之间的比较包含的两个秩和之间存在显著差异。总之，我们改良的评分量表为评估 SSc 中间质性肺受累的程度提供了有趣的附加数据。它与肺量计和 DLCO 及 DLCO/VA 呈反比。病变的双侧性与肺损伤成正比。
