Zhang Kemin, Shi Bing, Zhai Qiang, Jiang Lihui, Wang Xiaoxue, Jiang Shan, Sun Hongyan
Department of Radiology, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Department of radiology, Binhai New Area Hospital of Traditional Chinese Medicine, Tianjin, China.
Medicine (Baltimore). 2020 May;99(20):e19948. doi: 10.1097/MD.0000000000019948.
There are limited systematic studies on hematologic disease complicated by air leak syndrome (ALS). Physicians in radiology departments and hematology departments have a limited awareness of ALS.The aim of this study was to explore the similarities and differences in clinical data between the clinical group and imaging group in patients with hematologic disease complicated by ALS.Clinical and CT data for 59 patients with hematologic disease complicated by ALS in our hospital were retrospectively reviewed. Patients were assessed by clinical grouping and image grouping. Data were compared between groups, and P < .05 was considered statistically significant.Dyspnea occurred more often in the allo-HSCT (allogeneic hematopoietic stem cell transplantation) group than that in the non-allo-HSCT group (68.8% vs 4.7%, P < .001), there were statistically significant differences in inducing factors between groups, and differences in other aspects were not statistically significant. Chest tightness and dyspnea occurred more often in the allo-HSCT with BO/BOOP (bronchiolitis Obliteran/bronchiolitis obliterans organizing pneumonia) group than those in the allo-HSCT without BO/BOOP group (80.0% vs 9.1%, P = .013), and differences in other aspects were not statistically significant. Chest pain occurred more often in the HPT (hydropneumothorax) group than that in the other 3 groups (pure pneumothorax [PT], pulmonary interstitial emphysema [PIE], complex ALS) (71.4% vs 11.1%, 0.0%, and 26.5%, P = .005); ALS thickness in the HPT group was greater than that in the other 2 groups (PIE and complex ALS) (19.7 vs 3.5 cm and 9.5 cm, P = .001); catheter drainage occurred more often in the HPT group than that in the other three groups (PT, PIE, complexALS) (64.3% vs 22.2%, 0.0%, and 2.9%, P = .001).ALS is a high risk in male patients who have a low BMI, have leukemia as a basic disease, and have basic lung diseases (eg, BO/BOOP). CT types are mainly complex ALS, HPT, and pure PT. In addition, clinical symptoms for patients in the HPT group are severe, and there is a high prevalence of catheter drainage.
关于血液系统疾病合并空气泄漏综合征(ALS)的系统研究有限。放射科和血液科医生对ALS的认识有限。本研究的目的是探讨血液系统疾病合并ALS患者临床组和影像组临床资料的异同。对我院59例血液系统疾病合并ALS患者的临床和CT资料进行回顾性分析。患者按临床分组和影像分组进行评估。对组间数据进行比较,P<0.05被认为具有统计学意义。异基因造血干细胞移植(allo-HSCT)组呼吸困难的发生率高于非allo-HSCT组(68.8%对4.7%,P<0.001),组间诱发因素存在统计学差异,其他方面差异无统计学意义。allo-HSCT合并闭塞性细支气管炎/闭塞性细支气管炎机化性肺炎(BO/BOOP)组胸闷和呼吸困难的发生率高于allo-HSCT无BO/BOOP组(80.0%对9.1%,P=0.013),其他方面差异无统计学意义。血气胸(HPT)组胸痛的发生率高于其他3组(单纯气胸[PT]、肺间质肺气肿[PIE]、复杂性ALS)(71.4%对11.1%、0.0%和26.5%,P=0.005);HPT组ALS厚度大于其他2组(PIE和复杂性ALS)(19.7对3.5cm和9.5cm,P=0.001);HPT组导管引流的发生率高于其他3组(PT、PIE、复杂性ALS)(64.3%对22.2%、0.0%和2.9%,P=0.001)。ALS在BMI低、以白血病为基础疾病且有基础肺部疾病(如BO/BOOP)的男性患者中是一种高风险。CT类型主要为复杂性ALS、HPT和单纯PT。此外,HPT组患者临床症状严重,导管引流发生率高。