| 邹利光,戚跃勇,文利,戴书华,张启川.难治性哮喘的临床特征及其肺部改变的HRCT特点[J].中国医学影像技术,2015,31(2):177~180 |
| 难治性哮喘的临床特征及其肺部改变的HRCT特点 |
| Clinical characteristics and HRCT features of lung and airway changes in refractory asthma |
| 投稿时间：2014-10-02 修订日期：2014-12-02 |
| DOI：10.13929/j.1003-3289.2015.02.005 |
| 中文关键词: 哮喘 支气管 肺功能试验 体层摄影术,X线计算机 |
| 英文关键词:Asthma Bronchi Pulmonary function test Tomography, X-ray computed |
| 基金项目:国家卫生和计划生育委员会公益性行业科研专项基金(201402013)、第三军医大学临床科研基金(2009XLC19) |
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| 中文摘要: |
| 目的 分析难治性哮喘的临床特征及肺部改变的高分辨CT(HRCT)表现。方法 收集难治性哮喘患者53例(哮喘组),均接受肺功能检查(PFT)、诱导痰细胞分类计数和胸部HRCT,分析临床特点,对肺部和支气管HRCT改变进行描述观察和测量分析。另选择临床病史和CT检查肺部无明显异常的志愿者50例(对照组)。结果 哮喘组患者接受吸入糖皮质激素联合长效β2受体激动剂治疗3个月以上,仍有92.45%(49/53)的患者存在持续气流受限;诱导痰细胞分类计数,嗜酸粒细胞增多36例,中性粒细胞增多17例。胸部HRCT描述观察结果,46例(46/53, 86.79%)可见肺部异常,其中,支气管壁增厚38例、支气管扩张15例、肺气肿8例、肺部感染7例、支气管黏液嵌塞5例。胸部HRCT测量分析结果,段支气管和亚段支气管管壁厚度(T)分别为(1.6±0.6)mm、(1.3±0.5)mm,管腔内径分别为(2.4±0.6)mm、(1.7±0.5)mm,管外径(D)分别为(5.6±0.7)mm、(4.5±0.6)mm,管壁面积分别为(23.3±6.5)mm2、(17.6±4.5)mm2,T/D比值分别为0.28±0.08、0.29±0.09。结论 难治性哮喘的主要临床特征为不同程度的气道重构、不完全可逆的气流受限和气道炎症,胸部HRCT有助于难治性哮喘的临床综合评估。 |
| 英文摘要: |
| Objective To analyze the clinical characteristics and high resolution CT (HRCT) features of lung and airway changes in refractory asthma. Methods Fifty-three cases of refractory asthma (asthma group) were reviewed retrospectively, all patients underwent pulmonary function test (PFT), induced sputum cell classification and counting, and chest HRCT. The clinical characteristics were summarized, and HRCT changes of lung and airway were analyzed qualitatively and quantitatively. Another fifty subjects of no respiratory disease history and abnormal chest CT were enrolled as control group. Results In asthma group, treated with inhaled corticosteroids (ICS) combined with long action beta-2 agonists (LABA) for more than 3 months, 92.45% (49/53) cases were still with persistent airflow limitation. With induced sputum cell classification and counting, 36 cases showed increasing eosinophilia and 17 cases showed increasing neutrophils. Qualitative analysis of chest HRCT, 46 cases (46/53, 86.79%) showed pulmonary abnormalities, including bronchial wall thickening in 38 cases, bronchiectasis in 15 cases, emphysema in 8 cases, pulmonary infection in 7 cases, bronchial mucoid impaction in 5 cases. Quantitative analysis of chest HRCT of asthma group, segmental and subsegmental bronchial wall thickness (T) were (1.6±0.6)mm, (1.3±0.5)mm, lumen diameter were (2.4±0.6)mm, (1.7±0.5)mm, outer diameter (D) were (5.6±0.7)mm, (4.5±0.6)mm, wall area were (23.3±6.5)mm2, (17.6±4.5)mm2, and T/D ratio were 0.28±0.08, 0.29±0.09. Conclusion Airway remodeling, incomplete reversible airflow limitation and airway inflammation exist in refractory asthma patients. Chest HRCT examination is essential for the clinical comprehensive evaluation of refractory asthma. |
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