CT肺功能指标判断评价石棉肺患者呼吸功能的研究

目的 采用多层螺旋CT肺功能成像技术评价石棉肺患者的呼吸功能障碍程度和肺功能指标的改变及特点.方法 61例石棉肺患者与30名健康者根据用力肺活量和第1秒用力肺活量分为肺呼吸功能正常组、轻度损伤组、中重度损伤组.对每个受检者分别在深吸气末和深呼气末屏住气行全肺扫描,对肺容积、肺密度、小气道指标进行测定.结果 肺呼吸功能正常组、轻度损伤组、中重度损伤组的各项肺容积指标(吸气与呼气末肺容积、容积差、容积比)差异具有统计学意义(均P＜0.05);各项平均肺密度指标(吸气与呼气末平均肺密度、肺密度差、肺密度比)差异具有统计学意义(均P＜0.05);各项小气道指标(吸气与呼气末壁厚直径比率、支气管壁面积率)差异具有统计学意义(均P＜0.05).结论 CT肺功能成像技术可以用来评价石棉肺患者的呼吸功能障碍程度.随着石棉肺患者肺呼吸功能障碍的发展,其肺总量降低,双肺的残气量逐渐增多,肺气肿逐渐加重,小气道壁和肺泡隔纤维性肥厚逐渐增厚.

Evaluation of respiratory dysfunction in patients with asbestos lung based on pulmonary function indexes utilizing CT

Objective To evaluate the changes and characteristics of respiratory function and pulmonary function in patients with asbestosis by multi-slice spiral CT imaging.Methods 61 asbestosis patents and 30 healthy subjects were enrolled and divided into normal re spiratory function group,mild injury group and moderate/severe injury group according to forced vital capacity and forced expiratory volume in one second.The lungs were scanned at the end of inspiratory and expiratory phase,and the lung volume,lung density and small airway index were measured.Results There were significant differences in lung volume (inspiratory and expiratory volume,volume difference,and volume ratio) among the normal group,the mild injury group and the moderate/severe injury group (all P＜0.05).There were statistically significant differences in the mean lung density (lung density at the end of inspiratory and expiratory phase,lung density difference,lung density ratio) among the three groups (all P＜0.05).There were significant differences in the small airway indexes (tracheal wall thickness ratio at the end of inspiratory and expiratory phase,bronchial wall area ratio) among the three groups (all P＜0.05).Conclusions CT lung function imaging techniques can be used to assess the degree of respiratory dysfunction in asbestosis patients.With the development of pulmonary respiratory dysfunction,the total lung volume decreased,the amount of lungs gradually increased,emphysema gradually increased,and the thickness of small airway wall and alveolar fibrous hypertrophy gradually increased.