结缔组织病与肺密度异常的相关性研究

Correlation between the diffuse connective tissue diseases and pulmonary density

目的应用多层螺旋CT(MSCT)肺密度测定软件,找出肺密度变化与弥漫性结缔组织病(CTD)之间的相关性,探讨其应用价值。方法对222例临床已确诊为CTD的患者和50例体检者,利用MSCT附带的Pulmo自动评估软件测定上、中、下肺区的平均CT值及像素的频率分布(即像素指数)并进行HRCT胸部扫描,依据HRCT是否具有肺间质病变及其程度和肺密度异常增高,经统计学处理,分析肺密度异常与结缔组织病之间的关系。结果222例CTD的病例中,197例平均肺密度有不同程度的增高、像素分布异常和曲线波峰降低并右移,25例患者的平均肺密度和像素分布曲线表现正常,经Spearman等级相关分析和U检验:rs=0.795,U=11.82,P<0.001,结缔组织病和肺密度异常增高之间具有明显的等级相关性。50例体检者中42例平均肺密度和像素分布曲线表现正常,8例平均肺密度有不同程度的异常和像素分布曲线的异常,无相关关系存在。结论平均肺密度和像素分布曲线的异常与CTD致肺间质病变及其程度具有相关性。肺密度异常对早期诊断CTD所致的肺间质病变有一定的应用价值。

Objective To study the correlation between the pulmonary density changes and diffuse connective tissue disease (CTD) by measuring pulmonary density with multi-spiral CT (MSCT). Methods Pulmonary density was measured by MSCT in 222 patients with CTD and 50 normal individuals.The average attenuation values and their frequency distribution (i.e.pixel index,PI) of superior, middle and inferior lung regions were respectively assessed with Pulmo of semiautomatic evaluation software enclosed in MSCT unit. All patients also underwent HRCT of thorax.The relationship between the abnormal pulmonary density and CTD were statistically analyzed. Results 197 of 222 cases with CTD had a high averaged pulmonary density and their pixel indexes were abnormal.The curve lowered its peak and shifted to the right. Meanwhile the remaining 25 cases of 222 cases with CTD kept normal.Analyzed with Spearman’s rank correlation and U test, there existed a significant correlation between the increase of pulmonary density and CTD rs = 0.795,U = 11.82,P <0.001.42 of 50 normal individuals showed that the average pulmonary density and the curve peak were normal, the other 8 abnormal, which meant there was no correlation. Conclusions There is a correlation between abnormal pulmonary density and CTD, which is helpful for the diagnosis of CTD with pulmonary interstitial diseases.