Le Rouzic Olivier, Bendaoud Sofiane, Chenivesse Cécile, Rémy Jacques, Wallaert Benoit
Clinique des Maladies Respiratoires, Centre de compétence Maladies Pulmonaires Rares, Hôpital Calmette, Centre Régional Hospitalier et Universitaire, 59037 Lille..
Sarcoidosis Vasc Diffuse Lung Dis. 2016 Jan 18;32(4):353-9.
Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial pneumonia with a poor prognosis, and there is a clear need to identify factors predictive of disease progression and survival. Previous studies have suggested that patient survival may be associated with specific features on chest CT. Here, we evaluated the prognostic value of the initial high-resolution CT (HRCT) pattern according to the classification recommended by the most recent guidelines for IPF.
A total of 66 patients diagnosed with IPF between 2000 and 2010 were included in this retrospective study. Patients were classified into three groups based on the pattern of their initial HRCT: definite usual interstitial pneumonia (UIP) (UIPdef n = 26), possible UIP (UIPposs, n = 29), or inconsistent with UIP (UIPincons n = 11). Epidemiological data, functional data, and patient survival were compared.
The median survival time was 30, 46, and 107 months for UIPdef, UIPposs, and UIPincons groups, respectively (p = 0.51). Patients with UIPdef pattern HRCT were more likely to be former smokers (p = 0.007) in comparison with UIPincons, to have a lower diffusing capacity of the lung for carbon monoxide in comparison with UIPposs (p = 0.01) and to have a higher estimated systolic pulmonary artery pressure (p = 0.002). Patients with UIPincons pattern HRCT were more likely to be younger (p = 0.004).
There were no significant difference in survival between the three patient groups categorized by their initial chest HRCT pattern.
特发性肺纤维化（IPF）是一种预后较差的慢性间质性肺炎，明确需要识别预测疾病进展和生存的因素。既往研究表明，患者生存可能与胸部CT的特定特征相关。在此，我们根据IPF最新指南推荐的分类方法，评估了初始高分辨率CT（HRCT）模式的预后价值。
本回顾性研究纳入了2000年至2010年间诊断为IPF的66例患者。根据初始HRCT模式将患者分为三组：明确的普通型间质性肺炎（UIP）（UIPdef，n = 26）、可能的UIP（UIPposs，n = 29）或不符合UIP（UIPincons，n = 11）。比较了流行病学数据、功能数据和患者生存情况。
UIPdef、UIPposs和UIPincons组的中位生存时间分别为30、46和107个月（p = 0.51）。与UIPincons相比，HRCT表现为UIPdef模式的患者更可能是既往吸烟者（p = 0.007），与UIPposs相比，其一氧化碳肺弥散能力较低（p = 0.01），且估计的收缩期肺动脉压较高（p = 0.002）。HRCT表现为UIPincons模式的患者更可能较年轻（p = 0.004）。
根据初始胸部HRCT模式分类的三组患者在生存方面无显著差异。
