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[胸部结节病的X线、实验室及功能方面的相似性]

[X-ray, laboratory, and functional parallels in intrathoracic sarcoidosis].

作者信息

Vizel I Yu, Vizel A A, Shaimuratov R I

机构信息

Department of Phtisiopulmonology, Kazan State Medical University, Ministry of Health of Russia, Kazan, Russia.

出版信息

Ter Arkh. 2015;87(3):48-52. doi: 10.17116/terarkh201587348-52.

Abstract

AIM

to compare respiratory function and laboratory data with the radiographic stages of intrathoracic sarcoidosis.

SUBJECTS AND METHODS

Three hundred and eleven patients (70.4% for women and 29.6% for men; mean age, 44.7±0.6 years) with histologically verified sarcoidosis underwent X-ray computed tomography, spirography, estimation of carbon monoxide diffusing capacity (DLCO), oxygen saturation, blood count and serum total calcium blood test. The patients were assigned according to sarcoidosis stages as follows: 3.9% with stage 0; 16.4% with stage I; 65.3% with stage II; 13.2% with stage III; 1.3% with stage IV, and 12.9% with Löfgren's syndrome. Results. DLCo decreased together with an increasing sarcoidosis stage (<80% of the due X2=8.69 for DLCO; p=0.057); the difference was significant between stages I (84.2±2.8%) and III (76.1±2.9%, p=0.05). According to the radiographic changes, there were decreases in forced vital capacity (FVC) from 99.0±2.5% in stage I to 76.1±3.5% in Stage IV and in forced instantaneous expiratory flow rate at 75% of lung volume (FEF75) from 64.4±3.1 to 44.0±5.9%, respectively. DLCO correlated with FVC, peak expiratory flow, and FEF, (p<0.01) and arterial oxygen saturation (SaO2) did only with FVC. There was a strong association between the decrease in DLCO and FVC below 80% of the due values (X2=28.23; d.f.=1; p<0.001). L6fgren's syndrome failed to affect functional data. In the patients with Löfgren's syndrome, the serum level of calcium was significantly lower (2.09±0.10 versus 2.35±0.02 mmol/l(p=0.023); however, this indicator did not significantly differ between the radiological stages of intrathoracic sarcoidosis.

CONCLUSION

In sarcoidosis, the changes in DLCO and FVC vary with radiological stages. Decreased SaG2 was observed in Stage IV. The total level of total blood calcium is an indicator independent of the radiological stages of sarcoidosis.

摘要

目的

比较胸内结节病的呼吸功能和实验室数据与放射学分期。

对象与方法

311例经组织学证实的结节病患者(女性占70.4%,男性占29.6%;平均年龄44.7±0.6岁)接受了X线计算机断层扫描、肺功能仪检查、一氧化碳弥散量(DLCO)测定、血氧饱和度测定、血常规及血清总钙检测。患者根据结节病分期分组如下:0期占3.9%;I期占16.4%;II期占65.3%;III期占13.2%;IV期占1.3%; Löfgren综合征占12.9%。结果。DLCO随着结节病分期增加而降低(<预期值的80%,DLCO的X2=8.69;p=0.057);I期(84.2±2.8%)和III期(76.1±2.9%,p=0.05)之间差异有统计学意义。根据放射学改变,用力肺活量(FVC)从I期的99.0±2.5%降至IV期的76.1±3.5%,肺容积75%时的用力瞬间呼气流量(FEF75)分别从64.4±3.1降至44.0±5.9%。DLCO与FVC、呼气峰值流量和FEF相关(p<0.01),而动脉血氧饱和度(SaO2)仅与FVC相关。DLCO和FVC降至预期值的80%以下之间存在强关联(X2=28.23;自由度=1;p<0.001)。Löfgren综合征未影响功能数据。Löfgren综合征患者的血清钙水平显著较低(2.09±0.10对2.35±0.02 mmol/l,p=0.023);然而,该指标在胸内结节病的不同放射学分期之间无显著差异。

结论

在结节病中,DLCO和FVC的变化随放射学分期而异。IV期观察到SaO2降低。血清总钙水平是一个与结节病放射学分期无关的指标。

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