运动弥散量测定对弥漫性肺间质纤维化的诊断价值

Diagnostic Value of Exercise Diffusion Capacity Test on Diffuse Pulmonary Fibrosis

为给弥漫性肺间质纤维化的实验室诊断提供依据，作者测定了１６例弥漫性肺间质纤维化（ＤＰＦ）、１９例间质性肺炎（ＩＰ）、１７例慢性阻塞性肺病（ＣＯＰＤ）患者和２２例正常健康人运动前后肺一氧化碳弥散量（ＤＬＣＯ）以及５项肺通气、肺容量指标。结果显示：正常人运动后ＤＬＣＯ明显上升；ＤＰＦ组运动前ＤＬＣＯ即已降低，运动后ＤＬＣＯ进一步降低，改变率达１７．９５％（Ｐ＜０．００１）；而ＩＰ组、ＣＯＰＤ组运动前后ＤＬＣＯ无差异，表明运动前后ＤＬＣＯ测定对ＤＰＦ有重要诊断价值。２例运动后ＤＬＣＯ降低的ＩＰ患者经追踪观察后发展为ＤＰＦ，提示ＩＰ运动后ＤＬＣＯ降低者应警惕其发展为ＤＰＦ，对预测ＩＰ发展为ＤＰＦ有一定的临床意义。

Diffusion capacity for carbon monoxide of the lung(D LCO) before and after exercise test and 5 routine pulmonary function tests were conducted in 16 patients with diffuse pulmonary fibrosis (DPF),19 patients with interstitial pneumonia (IP),17 patients with COPD,and 22 normal subjects.The data showed:in normal subjects the D LCO after exercise increased significantly compared with before ( P <0.001).But in DPF group the D LCO before exercise was below the normal range,and it went down further after exercise,the decreasing rate being 17.95%( P <0.001).The D LCO in IP and COPD groups did not significantly change before and after the exercise.Two cases of interstitial pneumonia,who had a reduced D LCO after exercise,were followed up for 0.5 1.0 year,and both patients developed into DPF by that time.The results suggest that the D LCO measure before and after exercise test may have important value for DPF diagnosis,and a reduced D LCO after exercise test in IP patients may warn the development from IP into DPF.