结节病胸部CT和TBLB病理组织学所见与肺功能关系的研究

目的:探讨结节病胸部CT扫描所见及经支气管肺活检(TBLB)病理组织学不同类型与肺功能改变的关系.方法:结节病患者46例,接受肺功能、胸部CT检查,其中16例接受TBLB检查.结果:胸部CT扫描肺病变程度分别与肺活量(VC)和弥散功能(DLco)呈直线负相关(r=-0.64,P<0.01;r=-0.57,P<0.05).TBLB标本间质纤维组织增生组与正常组相比, VC降低(P<0.05);肉芽肿形成组与未见肉芽肿组相比,肺功能无明显差别.结论:结节病患者的胸部CT所见和肺功能有关,但尚不足以准确评估结节病患者VC和DLco的改变.结节病TBLB标本病理出现纤维组织增生的个体更容易出现VC的降低.胸部CT、TBLB和肺功能应同步检查互相补充,以正确诊断结节病及评价病情.

Correlation of pulmonary function with findings of CT and histopathology of the transbronchial lung biopsy specimens in sarcoidosis

Objective:To study the relationship between the typeso f computed tomography (CT) and histopathology of transbrochial lung biopsy (TBLB ) specimens in sarcoidosis and parameters of pulmonary function test. M ethods: The clinical and laboratory data of 46 patients with sarcoidosi s were included. All of these patients received CT and pulmonary function test,and 16 of them received TBLB. Results: The severity of parench ymal changes on the CT scan was significantly correlated vital capacity (VC)( r=-0.64,P<0.01)and diffusing capacity (DLco)(r=-0.57,P<0.05).The VC decreased in the patients with the fibrous tissue proliferati on in TBLB specimens but not in those with the normal fibrous tissue( P<0.05). Both in group with and without presence of non-necrotizing granulom ata in specimens, no difference of pulmonary function was found. Conclu sion: The severity of parenchymal changes on the CT scan was associatedwith parameters of pulmonary function test but may not be precisely used in eva luation of VC and DLco in sarcoidosis. The VC decreased with the fibrous tissueproliferation in TBLB specimens in sarcoidosis. The CT, TBLB, and pulmonary func tion test should be performed in diagnosis and assessment of sarcoidosis.