结节病患者的气流阻塞及其影响因素分析

Airflow obstruction in sarcoidosis and the influencing factors

目的探讨结节病患者的气流阻塞及其影响因素。方法回顾性分析我院18年来收治的31例结节病患者的临床资料,比较肺功能正常者(A组)、阻塞性通气功能障碍者(B组)和非阻塞性肺功能异常者(C组)的肺功能、影像学、纤维支气管镜下表现、支气管肺泡灌洗液(BALF)细胞学、血清血管紧张素转换酶抑制剂(ACEI)水平的差异。结果B组患者FEV1%与小气道功能指标较A组和C组显著降低。B组和C组的肺内网状结节纤维影出现比例显著高于A组。三组患者纤支镜下改变、支气管肺泡灌洗液的细胞学、ACEI水平等比较均差异无显著性。结论结节病患者可出现阻塞性通气功能障碍,小气道及其周围肺组织病变导致的气道结构改变可能与气流阻塞关系密切。

Objective To analyze the airflow obstruction of sarcoidosis patients and the influencing factors. Methods Clinical data of 31 patients with sarcoidosis from April 1989 to September 2007 were reviewed. Among the patients with normal pulmonary function test （ PFT）, （ Group A ）, airflow obstruction （ Group B ） and non-obstructive abnormal PFT （ Group C ） , the results of PFT, radiologieal mard-festations,bronchoscope examination,bronchoalveolar lavage fluid（BALF） cytology and serum angiotensin converting enzyme （ACEI） level were compared. Results Compared to Group A and C,FEV1% and small airway function parameters of patients of Group B were decreased significantly. Reticular-nodular-fibrotic pattern was more commonly found in the lung CT of Group B and C than that in Group A. Results of bronchoscope examination;BALF cytology and ACEI level were not significantly different among the three groups. Conclusions Patients with sarcoidosis might be with obstructive airflow, and structural changes of small airway resulting from its pathological processes as well as of surrounding pulmonary tissue might have close relationship with airflow obstruction.