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变应性支气管肺曲霉病中哮喘严重程度、IgE水平、肺量计检查结果与高分辨率CT表现的相关性

Correlation of asthma severity, IgE level, and spirometry results with HRCT findings in allergic bronchopulmonary aspergillosis.

作者信息

Neyaz Zafar, Hashim Zia, Kumar Sunil, Nath Alok, Khan Ajmal, Mohindro Namita

机构信息

Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareilly Road, Lucknow, Uttar Pradesh, India.

Department of Pulmonary Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareilly Road, Lucknow, Uttar Pradesh, India.

出版信息

Indian J Radiol Imaging. 2020 Apr-Jun;30(2):163-169. doi: 10.4103/ijri.IJRI_443_19. Epub 2020 Jul 13.

Abstract

CONTEXT

Few studies have been done for correlating asthma severity, IgE level, and spirometry results with high-resolution computed tomographic (HRCT) findings in allergic bronchopulmonary aspergillosis (ABPA).

AIMS

This prospective observational study was conducted to correlate asthma severity, IgE level, and spirometry results with HRCT findings in ABPA.

SETTINGS AND DESIGN

Prospective observational.

SUBJECTS AND METHODS

Fifty consecutive adult patients with asthma and positive specific IgE (>0.35 kUA/L) to were recruited from October 2015 to July 2017. Asthma severity, IgE levels, and spirometry results were correlated with HRCT score, bronchiectasis score, air trapping segments, and low-attenuation lung volume on inspiratory CT and expiratory CT.

STATISTICAL ANALYSIS USED

One way ANOVA, Spearman's correlation coefficients.

RESULTS

Asthma severity showed a significant positive correlation with HRCT score and bronchiectasis score. MEF pre and postbronchodilator values showed a significant negative correlation with HRCT score, bronchiectasis score, and percentage expiratory volumes -851 to -950 HU voxels. FEV1 prebronchodilator value showed a significant negative correlation with percentage expiratory volume -851 to -950 HU voxels and percentage expiratory volume -851 to -1024 HU voxels. Specific IgE antibody level showed a significant positive correlation with bronchiectasis score.

CONCLUSIONS

Asthma severity, specific IgE level, and MEF values showed a good correlation with HRCT findings. The restrictive pattern is common on spirometry in patients of ABPA. In addition to central bronchiectasis, peripheral bronchial and small airway involvement was an important finding in ABPA. Expiratory HRCT may reveal air trapping in patients having no abnormality on inspiratory CT.

摘要

背景

关于变应性支气管肺曲霉病(ABPA)中哮喘严重程度、免疫球蛋白E(IgE)水平和肺量计检查结果与高分辨率计算机断层扫描(HRCT)表现之间相关性的研究较少。

目的

本前瞻性观察性研究旨在探讨ABPA患者的哮喘严重程度、IgE水平和肺量计检查结果与HRCT表现之间的相关性。

设置与设计

前瞻性观察性研究。

研究对象与方法

2015年10月至2017年7月,连续招募了50例哮喘成年患者,其针对烟曲霉的特异性IgE呈阳性(>0.35 kUA/L)。将哮喘严重程度、IgE水平和肺量计检查结果与HRCT评分、支气管扩张评分、气体陷闭节段以及吸气期CT和呼气期CT上的低衰减肺容积进行相关性分析。

统计分析方法

单因素方差分析、Spearman相关系数。

结果

哮喘严重程度与HRCT评分和支气管扩张评分呈显著正相关。支气管舒张前后的最大呼气流量(MEF)值与HRCT评分、支气管扩张评分以及呼气期容积百分比-851至-950亨氏单位(HU)体素呈显著负相关。支气管舒张前第1秒用力呼气容积(FEV1)值与呼气期容积百分比-851至-950 HU体素以及呼气期容积百分比-851至-1024 HU体素呈显著负相关。特异性IgE抗体水平与支气管扩张评分呈显著正相关。

结论

哮喘严重程度、特异性IgE水平和MEF值与HRCT表现具有良好的相关性。ABPA患者肺量计检查常见限制性模式。除中央型支气管扩张外,外周支气管和小气道受累是ABPA的一个重要表现。呼气期HRCT可能显示吸气期CT无异常的患者存在气体陷闭。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ebe/7546303/8356dc25cf0e/IJRI-30-163-g001.jpg

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