无症状非吸烟者肺空气潴留的HRCT评估及其与肺功能的相关性研究

目的分析不同年龄组无症状非吸烟者呼气相高分辨率CT（HRCT）空气潴留情况,探讨年龄对呼气相CT空气潴留的影响以及空气潴留与肺功能的相关性。资料与方法对经严格选择的63名无症状非吸烟者进行肺吸气末与呼气末HRCT扫描,其中32名进行肺功能测试。将所有受试者按年龄分为5组,对呼气相HRCT上空气潴留进行定量分析并与肺功能指标进行相关性分析。结果所有受试者吸气相HRCT均未见异常,呼气相HRCT空气潴留总的出现率为39．7％（25／63）,其中Ⅰ型22．2％（14／63）,Ⅱ型17．5％（11／63）,各组均未出现Ⅲ型空气潴留。以小叶型空气潴留为主者16例,以肺段型为主者9例,未出现肺叶型。空气潴留组与无空气潴留组之间的用力肺活量（FVC）和1s用力呼气容积（FEV1）／FVC平均值之间存在显著差异（P〈0．05）;FEV1／FVC更是与空气潴留的分级有明显的相关性（r=-0．529,P〈0．05）。结论无症状非吸烟者呼气相HRCT出现的空气潴留约40％．年龄为其形成原因之一。空气潴留的面积分级与FEV1／FVC呈明显的相关性。     

儿童哮喘肺HRCT空气潴留与肺功能的相关性研究

目的: 观察儿童哮喘患者呼气末HRCT空气潴留的表现;明确空气潴留的面积与肺功能阻塞性指标如FEV1、FEF25%～75%等的相关性.方法:选择21名哮喘儿童行呼气末HRCT扫描,并于同一天或第2天做肺功能检查.在HRCT上分别于上、中、下肺野选取2个可清晰显示空气潴留的层面.用一张规格为2mm×2mm的透明方格纸对空气潴留的面积进行评估.根据空气潴留面积占全肺面积的比例,将其分为3级:Ⅰ级<5%,Ⅱ级5%~25%,Ⅲ级>25%.然后将空气潴留的级别与肺功能的指标做相关性分析.结果:①哮喘儿童肺呼气末HRCT空气潴留出现率为90.5% (19/21);②下叶是空气潴留最好发的部位,占100% (19/19);③空气潴留级别与肺功能阻塞性指标FEV1、FEF25%～75%、FEF50%显著相关,相关系数分别为(r=-0.565,P<0.01;r=-0.499,P<0.05;r=-0.521,P<0.05).④肺功能正常的哮喘儿童肺HRCT空气潴留出现率为 87.5% (14/16).肺功能正常的哮喘儿童在肺HRCT可观察到明显的空气潴留征,其空气潴留级别可达到Ⅱ、Ⅲ级.结论:肺呼气末HRCT空气潴留可直观显示气道病变的不均匀分布及病变的严重程度;空气潴留征比肺功能异常改变出现早,其敏感性明显高于肺功能检查,可用于评价肺功能正常的哮喘儿童的小气道病变.     

空气潴留征在诊断肺弥漫性疾病中的价值

肺弥漫性疾病(diffuse lung diseases, DLD)是较为复杂的一组病变的总称,其广泛累及肺实质/肺间质,以后者为主.DLD X线胸片和CT呈现为弥漫性和多样性的病灶阴影,没有很明确的特征性表现.因此,若无病理对照而单纯从影像学角度出发,确诊很困难.高分辨CT(high resolution computed tomograghy, HRCT)DLD可以有多种表现,包括小结节影、磨玻璃影、网状阴影、空气潴留征(air trapping, AT)等.其中,AT可以出现在多种DLD中,认识和识别AT将有利于临床对DLD的诊断和鉴别诊断.本文简要介绍了AT及其在DLD诊断中的应用价值.     

吸烟与脑梗塞的相关性调查

为了解部队离退休老干部吸烟与脑梗塞患病率的关系,我们于1996-09-10～1997-09-01在膳食习惯,生活条件和所处环境基本相同的26个部队干休所的离退休老干部2568人进行了相关性流行病学调查。现将分析情况报告如下:1 对象与方法1.1 对象 成都市、绵阳市26个部队干休所的全部男性离退休干部共2568人,年龄60～90岁,平均69.4岁。1.2 方法 按统一调查表随访填写吸烟情况。吸     

无症状人群中肺部薄层CT上的空气潴留与年龄和吸烟之间的关系

空气潴留在呼气CT上表现为受累的肺实质较周围正常肺密度为低。它可见于肺气肿、哮喘、支扩、组织细胞增生症X、慢性气道病和儿童肺病中。但也曾见于无症状的吸烟或不吸烟人群中,但以往对此仅有少数报道,且被检查人数太少,多为青年人。作者目的是研究在无症状人群中空气潴留的发生率以及与年龄、吸烟的关系。本组共82例,均为20岁以     

吸烟饮酒与老年人卒中的相关性调查

随着老龄化社会的到来，急性脑血管病在老年人中的发病情况已受人们普遍重视，其致残率高，是严重威胁人类生命与健康的疾病之一。急性脑血管病在我国城市1975～1982年占死因第一位，1983年以后占死因第二位，全国由此病致死的人数占城市死亡总数的21％左右和农村的16％左右。吸烟、嗜酒及由此引起的疾病，是当今世界威胁公共卫生的最严重问题之一。研究表明：吸烟和饮酒都是脑卒中的的危险因素。我们通过对在重庆市社区居住的老年人群进行抽样调查，以探讨老年人吸烟、饮酒与急性脑血管病发病的关系。     

慢性肺心病二氧化碳潴留与低氯血症相关性分析

目的 :探讨慢性肺心病二氧化碳潴留与低氯血症的相关关系。方法 :同步检测 5 3例慢性肺心病急性发作期患者动脉血气和电解质。以PaCO2 ≥ 7.3kPa为界 ,分为CO2 潴留组和非CO2 潴留组 ,两组指标统计学处理 ,分析血氯与PaCO2 的相关性。结果 :CO2 潴留组发生低氯血症 74 1% (2 0 / 2 7) ,非CO2 潴留组低氯血症 4 2 3% (11/ 2 6 ) ,两组血氯、PaCO2 、HCO-3 比较有统计学差异 ,且血Cl-与PaCO2 呈显著负相关 (r=- 0 4 0 5 ,P <0 0 5 )。结论 :肺心病急性加重期的电解质紊乱常表现为低氯血症 ,并与PaCO2 呈显著负相关。治疗中及时补氯 ,不仅可纠正低氯血症 ,而且可以加速HCO-3 /Cl-交换 ,有助于CO2 排出。     

双相CT空气潴留征与半定量评分预测新型冠状病毒肺炎患者血气指标异常及进展为重症的价值

目的:探讨低剂量双相（吸气相与呼气相）CT空气潴留征及病灶范围半定量评分预测新型冠状病毒肺炎（COVID-19）患者重症及血气指标异常的价值。方法:前瞻性连续性纳入2020年1月23日至2月29日无锡市定点收治医院经核酸检测确诊并住院治疗的非重症COVID-19患者。所有患者入院时均接受低剂量双相CT检查且在病程中按时...     

吸烟与牙周病关系的研究调查

目的：调查研究吸烟与牙周病的关系。方法：411名男性公民，其中吸烟者254人，非吸烟者157人，调查他们的口腔卫生状况、牙周情况和吸烟状况，并对资料进行统计学分析。结果：吸烟者的软垢指数与非吸烟者无显著性差异。牙周指数CPITN在早晚期牙周炎区段则明显高于非吸烟者。同时在这区段牙齿缺失均数也高于非吸烟者。重度吸烟者牙周炎区段数高于轻中度吸烟者及不吸烟者。结论：调查结果提示吸烟可能是牙周病流行的一个重要因素。     

Correlation of aging and smoking with air trapping at thin-section CT of the lung in asymptomatic subjects

PURPOSE: To assess the frequency and degree of air trapping at thin-section computed tomography (CT) of the lung in relation to age and smoking history in asymptomatic subjects. MATERIALS AND METHODS: Thin-section CT of the lung was performed prospectively at end inspiration and end expiration in 82 subjects (27 smokers, 55 nonsmokers) without any history of pulmonary diseases and without present pulmonary symptoms. The frequency and degree of air trapping were evaluated according to age and smoking status. RESULTS: The overall frequency of air trapping was 52% (43 of 82 subjects, kappa = 0.72). Air trapping was found in three of 13 (23%), seven of 17 (41%), nine of 18 (50%), 11 of 17 (65%), and 13 of 17 (76%) subjects aged 21-30, 31-40, 41-50, 51-60, and greater than or equal to 61 years, respectively. The frequency of air trapping increased with age (P < .05). The degree of air trapping had a significant correlation with age (r = 0.523, P < .001) and was higher in smokers with a smoking history of more than 10 pack-years (P < .05). CONCLUSION: Air trapping was found in approximately 50% of asymptomatic subjects. The frequency of air trapping increased with age, and its severity increased with age and smoking.     

Expiratory CT in cigarette smokers: correlation between areas of decreased lung attenuation, pulmonary function tests and smoking history

The aim of this study was to determine the correlation between cigarette-smoke-related bronchial disease and air trapping as assessed by expiratory high-resolution CT (HRCT) scans. Thirty healthy subjects (11 non-smokers, 7 ex-smokers for > 2 years, 12 current smokers; age range 35–55 years) with a smoking history between 0 and 28.5 pack-years underwent pulmonary function tests (PFT) and HRCT in inspiration and expiration in supine and prone position. The extent of air trapping was scored in ventral and dorsal aspects of the upper, middle and lower lung portions. In 24 subjects (7 non-smokers, 7 ex-smokers, 10 current smokers) areas of focal air trapping were found, and were present significantly more often in dependent lung portions (p < 0.05) compared with non-dependent portions. No significant differences were found between apical and basal lung zones. Scores of focal air trapping were not significantly different between smokers and ex-smokers, but were significantly lower (p < 0.05) in non-smokers and showed a significant (p < 0.0005) correlation with pack-years. The degree of air trapping was also associated with several lung function tests, especially RV, DLCO, FRC, FEV1 and FEV1/VC. Air trapping is seen in smokers with normal PFT and correlates with the severity of the smoking history, independently of current smoking status. Received 4 August 1997; Revision received 12 January 1998; Accepted 14 January 1998     

Frequency and severity of air trapping at dynamic expiratory CT in patients with tracheobronchomalacia

OBJECTIVE: The purpose of this study was to compare the frequency and severity of air trapping in patients with and without tracheobronchomalacia using dynamic expiratory volumetric CT. MATERIALS AND METHODS: The study group consisted of 20 subjects, including 10 patients with bronchoscopically proven tracheobronchomalacia and 10 control subjects of similar ages without tracheobronchomalacia. All 20 subjects underwent MDCT performed at the end of deep inspiration and during dynamic expiration. The images were analyzed at three lung levels, and the extent of air trapping was assessed visually using a 5-point scale. For each subject, a total air-trapping score was derived by summing the values for the three lung levels (possible range, 0-12). Statistical analysis was performed using the Mann-Whitney U test. RESULTS: In the tracheobronchomalacia group, 10 (100%) of 10 patients showed air trapping, with a median score of 5 (range, 2-12). In the control group, six (60%) of 10 subjects showed air trapping, with a median score of 2 (range, 0-3). The median total air-trapping score was significantly higher (p < 0.001) for the tracheobronchomalacia group compared with the control group. Excessive central airway collapse (expiratory reduction in cross-sectional area of > 50%) was seen on CT scans in all tracheobronchomalacia patients but in none of the control subjects. CONCLUSION: Air trapping was observed with a higher frequency and greater severity in patients with tracheobronchomalacia than in a control group of patients of similar ages without tracheobronchomalacia.     

Functional significance of air trapping detected in moderate asthma

The aim of this study was to evaluate bronchial and lung abnormalities in patients suffering from moderate asthma as defined by international guidelines, with special attention to air trapping on CT in comparison with that detected in smoking and non-smoking normal subjects. Twenty-two patients classified as moderate asthma and control subjects including healthy volunteers, smokers (n = 10) or non-smokers (n = 12) were prospectively explored by high-resolution CT (HRCT) performed at suspended full inspiration and expiration. The same expiratory protocol was performed 15 min after inhalation of 200 μg of salbutamol. Patients underwent pulmonary function tests within the same week and bronchodilator response was assessed following inhalation of salbutamol. Abnormalities of bronchi and lung parenchyma on inspiratory CT and air trapping on expiratory CT, in dependent and non-dependent areas, were assessed and scored semi-quantitatively by two independent observers. Comparison of score mean values between the different groups was performed using Mann-Whitney test and Spearman correlation between CT findings and pulmonary function tests were calculated. Mosaic perfusion was observed in 23 % of asthmatics. Air-trapping scores were significantly higher in asthmatic patients than in non-smoking control subjects (p = 0.003), but not than in smokers. This difference was ascribed to non-dependent zones of the lung for which air-trapping scores were also higher in asthmatic patients (p = 0.003) and in smoking subjects (p = 0.004) than in normal controls. In the asthmatic group, a significant positive correlation was found between airways resistance and bronchial dilatation score (p = 0.01), and between small airways obstruction index and mosaic perfusion score (p = 0.05). In addition, both FEV1 and reversibility of small airways obstruction values correlated with air-trapping score (p = 0.03 and p = 0.007, respectively). No change could be detected in air-trapping score following salbutamol inhalation. Patients suffering from moderate asthma present mosaic perfusion and larger areas of air trapping than normal subjects, particularly in non-dependent areas of the lung. These lung abnormalities are related to small airways obstruction. Received: 28 December 1999; Revised: 27 April 2000; Accepted: 2 May 2000     

Value of air trapping in detection of small airways disease in smokers

Purpose: 
To test the hypothesis that diffuse and/or focal air trapping are sensitive indicators of airflow obstruction in smoker's small airways disease, when age, gender and presence of emphysematous lesions were allowed for. Material and Methods: 
Fifty-eight smokers and 34 never smokers, recruited from a randomized population study of men born in 1933, were investigated by HRCT and by extended pulmonary function tests, including a sensitive test for small airways disease (N₂ slope). Diffuse air trapping was evaluated by calculating a quotient of mean lung density at expiration and inspiration. Focal air trapping was scored visually by consensus. Results: 
Diffuse air trapping did not differ between non-emphysematous smokers and never smokers. Furthermore, diffuse air trapping correlated well to the quotient between the residual volume and total lung capacity (RV/TLC, p = 0.01) and was consequently higher in emphysematous smokers than in never smokers.
Focal air trapping was found as frequently in smokers without emphysema as in never smokers. Smokers with emphysema showed significantly less focal air trapping. Neither the N₂ slope nor any of the other lung function variables differed between those with and without focal air trapping among non-emphysematous smokers. Conclusion: 
Neither diffuse nor focal air trapping are sensitive indicators of smoker's small airways disease.     

Bronchoarterial ratio and bronchial wall thickness on high-resolution CT in asymptomatic subjects: correlation with age and smoking

OBJECTIVE: The purpose of this study was to determine whether the values of the bronchoarterial ratio and bronchial wall thickness, as viewed during high-resolution CT, relate to age and smoking status in asymptomatic healthy subjects. SUBJECTS AND METHODS: High-resolution CT was performed prospectively in 85 subjects without cardiopulmonary disease. The subjects were divided into three groups according to age: 29 subjects were 21-40 years old; 29 subjects, 41-64 years old; and 27 subjects, 65 years or older. Both bronchoarterial ratios, defined as the diameter of the bronchial lumen divided by the diameter of its accompanying artery, and the T/D ratio, defined as wall thickness (T) divided by the total diameter of the bronchus (D), were measured at the segmental and subsegmental levels of the apical and posterior basal segments. Each calculated ratio was evaluated according to age and smoking status. RESULTS: Significant correlation was found between the bronchoarterial ratio and age (r = 0.768, p < 0.0001), with the bronchoarterial ratio increasing with age and exceeding 1 in 41% of subjects older than 65 years. No significant correlation was seen between the T/D ratio and age. No significant differences in bronchoarterial ratio and T/D ratio were seen between smokers and nonsmokers in subjects overall; but in the elderly group, the T/D ratio was significantly higher in smokers than in nonsmokers (p = 0.021). CONCLUSION: The bronchoarterial ratio is influenced by aging. The normal bronchoarterial ratio in a substantial number of subjects older than 65 years overlaps with the ratio considered to represent bronchiectasis. Thus, when this ratio is used for the quantitative analysis of pulmonary and cardiovascular disease, the influence of age should be considered.     

飞行员葡萄糖耐量与年龄的关系

目的探讨飞行员的葡萄糖耐量、血脂和血清胰岛素水平的变化与其年龄的关系。方法87名健康飞行员和80名健康地勤人员，分别按年龄分为3个小组，其组间距均为10岁。计算所有检查对象的体重指数(BMI)，并检测其血脂、葡萄糖耐量和血清胰岛素水平。结果随着年龄的增长，葡萄糖耐量逐渐减低，血脂和BMI增加，且飞行员比较突出；尤其是飞行员葡萄糖耐量试验3h血糖减低显著高于地面人员。年龄每增加10岁，飞行员空腹血糖增高0．3～0．8mmol／L，而高密度脂蛋白胆固醇水平降低0．2mmol／L。结论糖耐量减低的发生率随年龄增长而增加，所以对不同年龄飞行员的膳食及体育训练应当个体化。