慢性阻塞性肺疾病合并肺间质纤维化的临床研究

Clinical study of chronic obstructive pulmonary disease with pulmonary fibrosis

目的研究慢性阻塞性肺疾病(COPD)合并肺间质纤维化的临床特点及意义,并探讨其临床诊断要点。方法对近8年来临床确诊的36例COPD合并肺间质纤维化病例进行临床与影像学的回顾性分析研究,其中肺气肿合并肺纤维化11例,肺心病合并肺纤维化25例。结果COPD合并肺间质纤维化的临床表现多数界于上述两种病变之间,胸部X线及CT兼具二者特点,肺纤维化病变在肺心病组多见。结论COPD合并肺间质纤维化具有其独特的临床与影像学特征,其中临床症状及胸片是诊断的重要线索,高分辨率CT是临床确诊的最佳方法。

Objective To study the clinical characteristics and meanings of chronic obstructive pulmonary disease（COPD） with pulmonary fibrosis and clinical diagnostic standard. Methods Thirty-six patients with COPD and pulmonary fibrosis were found in the past eight years. Clinical and radiology characteristics were analyzed in the review. Eleven patients with emphysema and pulmonary fibrosis, twenty-five patients with pulmonary heart disease and pulmonary fibrosis were in thirty-six patients. Results Their clinical and radiology characteristics were those of both COPD and pulmonary fibrosis. Pulmonary fibrosis was more common in the patients with pulmonary heart disease. Conclusion COPD and pulmonary fibrosis had their clinical features. Clinical symptom and chest radiograph are main clues for diagnosis of COPD with pulmonary fibrosis, high resolution CT is a best way for discovering the coexistence of COPD with pulmonary fibrosis.