慢性阻塞性肺疾病合并肺间质纤维化的临床研究

目的分析慢性阻塞性肺疾病合并肺间质纤维化（IPF—COPD）的特点并探讨其临床意义。方法分析6年来我院发现的28例PIF-COPD患者的病史、临床表现、X线胸片、肺高分辫率CT（HR—CT）、血气分析和肺功能检查结果。结果PIF—COPD的临床表现介于上述两种疾病，常有长期大量吸烟史。X线胸片、HRCT兼有两种疾病的特点。其肺功能多为混合性通气功能障碍，一氧化碳弥散量（DLCO）多为中重度下降。血气以低氧血症为主，部分合并有二氧化碳潴留。结论COPD和IPF是两种不同疾病，但可以同时存在，其临床表现具有独特性。肺功能检查、血气分析、X线胸片和肺CT．尤其肺HR—CT可为确诊提供依据。

Clinical Analysis of Chronic Obstructive Pulmonary Disease with Pulmonary Interstitial Fibrosis

OBJECTIVE To analysis the clinical characteristics and explore the clinical significance of chronic obstructive pulmonary disease （COPD） with interstitial pulmonary fibrosis （IPF） . METHODS Twenty-eight patients with COPD and PIF were collected for study in the past six years. Clinical symptoms, radiographic features,HRCT of the chest, arterial blood gas analysis data, and lung function test were analyzed. RESULTS Their clinical features are those of both COPD and PIF, These patients had a long history of cigarette-smoking .X-rays and high resolution computed tomography （HR-CT） of lung demonstrated some features of both COPD and PIF .Lung function tests showed mixed ventilation disturbances and that DLCO was moderately or severely decreased. Arterial blood gas analysis data manifested mainly hypoxemia and partly coexited with hypercarbia. CONCLUSION Although COPD and IPF are two different diseases ,they could coexist in some patients which has specific clinical features. Lung function test, arterial blood gas analysis, radiography, especially HRCT of lung are important methods for diagnosing COPD with PIF.