国内肺纤维化合并肺气肿综合征临床特点的系统分析

目的 了解我国目前肺纤维化合并肺气肿综合征的临床特点.方法 检索所有国内中文发表的关于肺纤维化合并肺气肿综合征的临床病例报道并进行系统分析.结果 16篇文献符合标准,共统计纳入443例患者,男∶女=6.9∶1,吸烟者占81.6％.其中最常见症状是咳嗽(69.3％),其次是咳痰(64.5％)、呼吸困难(63.1％)、咯血(6.8％);查体最常见体征是爆裂音(80.2％)、杵状指(39.0％).影像学方面,最常见高分辨率CT表现是网格影(64.2％)、肺大疱(45.3％)、牵张性支气管扩张(15.4％).35.3％患者有肺动脉高压.基础疾病方面,最常见的是COPD (32.4％)、肺癌(15.4％)、肺结核(7.7％).肺功能方面,肺总量％ pred为(79.3±13.9)％,FVC％ pred为(71.9±17.3)％,FEV1％ pred为(63.6±22.3)％,FEV1/FCV为(72.7±9.8)％,残气量/肺总量为(41.2±10.1)％,DLCO％ pred为(40.9±13.8)％;血气分析方面,PaO2为(65.5±12.8) mmHg,PaCO2为(37.7±5.0) mmHg,SaO2为92.2±3.9,P(A-a) O2为(64.2±58.1) mmHg.结论 国内报道的肺纤维化合并肺气肿综合征的特点与国外基本相似.有待进一步大规模流行病学调查、免疫学机制的研究及高质量的临床试验.

Clinical characteristics of combined pulmonary fibrosis and emphysema in China: a systematic review

Objective To summarize the clinical features of combined pulmonary fibrosis and emphysema (CPFE) syndrome in China.Methods We searched the Chinese literatures to systematically analyze the characteristics of CPFE syndrome.Results 16 reports were including 443 cases,male∶ female=6.9 ∶ 1,most of them had smoken (81.6％).The most common systems were cough (69.3％),sputum (64.5％),dyspnea (63.1％),hemoptysis (6.8％).The most frequent physical signs were velcre tale (80.2 ％),clubbed-finger (39.0 ％).The most common high resolution CT performances were reticular opacities (64.2％),bullae (45.3％) and traction bronchiectasis (15.4％).35.3％ of the patients with CPFE syndrome had pulmonary arterial hypertension.The common underlying diseases were chronic obstructive pulmonary disease (32.4 ％),lung cancer (15.4 ％) and pulmonary tuberculosis (7.7 ％).The results of the pulmonary function tests showed that TLC％ pred was (79.3-±-13.9) ％,FVC％ pred was (71.9 ± 17.3) ％,FEV1 ％ pred was (63.6 ± 22.3) ％,FEV1/FCV was (72.7 ± 9.8) ％,RV/TLC was (41.2± 10.1) ％,DLCO％ pred was (40.9 ± 13.8) ％.The blood gas analysis results showed that PaO2 was (65.5±12.8) mmHg,PaCO2 was (37.7±5.0) mmHg,SaO2 was 92.2±3.9,P(A-a)O2 was (64.2± 58.1) mmHg.Conclusions The clinical features of CPFE syndrome in China are similar to the oversea literatures.