强直性脊柱炎肺部高分辨CT改变及与病程的关系

Lung Changes in Ankylosing Spondylitis with High Resolution CT and Correlation with Disease Duration

目的探讨强直性脊柱炎(AS)患者肺部高分辨CT(HRCT)表现及与病程的关系。方法28例确诊AS患者,根据病程分为3组。每位患者均作胸部平片,肺HRCT,肺功能检查。结果肺HRCT显示21例(75%)肺内病理性改变,其中1组3例,2组5例,3组13例。而全胸片仅3例(11%)显示肺内病理改变。HRCT显示AS最常见的肺内改变是肺气肿、间隔增厚、胸膜增厚,然后是结节影、胸膜下线。4名患者有肺尖纤维化。在非吸烟患者中间隔和胸膜增厚是最常见的改变。结论强直性脊柱炎患者的肺HRCT改变多样化,这些改变开始于疾病的早期阶段,随病程延长而发展。虽然吸烟也可并发肺部改变,但主要在间质炎症形成方面起主导作用。

Objective This study was to analyze the spectrum of the lung changes on high resolution CT （HRCT） and correlate the findings with disease duration in patients with ankylosing spondylitis （AS）. Methods Twenty eight initially diagnosed patients with AS,The patients were assigned to three groups depending on disease duration. All received examinations of pulmonary function tests （PFT）,plain chest radiography,HRCT, Results HRCT revealed pathology in 21 patients （75%） ,whereas plain chest radiography revealed pathology in 3 patients （11%）. Three patients in group 1,5 patients in group 2 and 13 patients in group 3 had pulmonary changes. Emphysema （12/ 28）,septal thickening （12/28） and pleural thickening （12/28） were the most common changes followed by nodule （11/28）and subpleural band formation（10/28）. Four patients had apical fibrosis（AF）. Septal and pleuaral thickening （both 5/14） were the most common changes when only nonsmokers were considered. Conclusion There is a wide spectrum in pulmonary changes in AS,these changes begin in early stages of the disease and increase with disease duration. Although smoking complicates the spectrum of changes in pulmonary parenchyma, they are predominately in the form of the interstitial inflammation.