Duan Jianghui, Xu Yanyan, Zhu Haixu, Zhang Haibo, Sun Shilong, Sun Hongliang, Wang Wu, Xie Sheng
Department of Radiology, China-Japan Friendship Hospital, Beijing Department of Radiology, The People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, China.
Medicine (Baltimore). 2018 Sep;97(36):e12205. doi: 10.1097/MD.0000000000012205.
To address the reliability of CT activity score (CTAS) and investigate the relationships between CTAS, lung function changes after treatment and the serum angiotensin-converting enzyme (SACE) levels.Fifty-seven sarcoidosis patients underwent chest high-resolution CT (HRCT) and spirometry, as well as SACE examination, were retrospectively analyzed. Follow-up spirometry in each patient was obtained about 6 months after the initial spirometry. The correlations between CTAS and pulmonary function changes were evaluated by Spearman correlation analysis. According to SACE status, patients were divided into normal and high level 2 subgroups. Comparisons of pulmonary function parameters, HRCT abnormalities extent scores between SACE normal and high 2 subgroups were performed with the Mann-Whitney U test or Independent samples t test.CTAS demonstrated significant correlations with lung function changes (Δ%VC: ρ= 0.543, P < .001; ΔFEV1.0/FVC:ρ = 0.417, P = .001; Δ%TLC: ρ = 0.309, P = .019). In addition, worse initial lung function, larger changes of lung function, and higher extent scores of HRCT were observed in SACE high-level subgroup.The findings of this study suggest that CTAS of initial HRCT is a promising index for disease activity in pulmonary sarcoidosis to some degree. Prospective studies with large cohort designed to address further verification are warranted before wide clinical practice.
为了评估CT活动评分（CTAS）的可靠性，并研究CTAS、治疗后肺功能变化与血清血管紧张素转换酶（SACE）水平之间的关系。对57例结节病患者进行回顾性分析，这些患者均接受了胸部高分辨率CT（HRCT）、肺功能测定以及SACE检查。每位患者在首次肺功能测定后约6个月进行随访肺功能测定。采用Spearman相关分析评估CTAS与肺功能变化之间的相关性。根据SACE状态，将患者分为正常和高水平2个亚组。采用Mann-Whitney U检验或独立样本t检验对SACE正常和高水平2个亚组之间的肺功能参数、HRCT异常程度评分进行比较。CTAS与肺功能变化显著相关（Δ%VC：ρ=0.543，P<0.001；ΔFEV1.0/FVC：ρ=0.417，P=0.001；Δ%TLC：ρ=0.309，P=0.019）。此外，SACE高水平亚组患者的初始肺功能更差、肺功能变化更大、HRCT异常程度评分更高。本研究结果表明，初始HRCT的CTAS在一定程度上是肺结节病疾病活动的一个有前景的指标。在广泛临床应用之前，有必要进行大规模队列的前瞻性研究以进一步验证。
