溃疡性结肠炎肺功能损伤特点

Characteristics of injured lung function in patients with ulcerative colitis

目的本文意在探寻溃疡性结肠炎(UC)不同分期、病情程度中肺功能损伤的特点,联系传统中医理论,指导临床诊治。方法选取2009年9月～2011年3月,北京、上海、河南、江苏等地三甲医院门诊及住院符合UC诊断且无呼吸系统疾病的患者,进行UC一般资料、症状、舌脉及相关危险因素调查,同时对病人进行肺部症状采集(咳嗽、气短、胸闷、咯痰、咯血)、肺功能检查。结果本研究症状调查共纳入261人,58.6%的UC病人会出现胸部症状,其中气短者占39.9%、咳嗽者28.4%;肺功能调查共纳入199人,199人中63.3%肺功能均有改变,其中活动期占53.3%,轻、中度者占53.8%;受损类型以气流受限(54.8%)、弥散量下降(51.6%)等异常较明显。结论绝大部分UC病人均会出现胸部症状、肺功能异常,气短、咳嗽症状明显,肺功能表现为不同程度的气流受限、弥散量下降、残总比升高等异常,且常与UC的活动性及病变程度相关,以活动期和轻、中度病患肺功能改变尤为突出。

Objective To explore the characteristics of injured lung function in different stages and degrees of ulcerative colitis（UC）,and guide clinical practice based on TCM theory.Methods The patients without diseases of respiratory system accorded with UC diagnosis were selected from outpatient department and wards of third-grade class-A hospitals in Beijing,Shanghai,Henan and Jiangsu from Sept.2009 to March,2011.The general material,symptoms,tongue and pulse manifestations and relevant risk factors of UC were investigated and at the same time,blood test and the examinations of lung function,chest X-ray,colonoscopy and histopathology were given to the patients.Results The symptom survey in this study included 261 patients.Of UC patients,there were 58.6% with chest symptoms,39.9% with short breath,28.4% with cough.The lung function survey in this stndy included 199 patients.Of 199 patients,there were 63.3% with the changes of lung function,and among which,53.3% in active stage and 53.8% with mild or moderate impairment of lung function.The types of the impairment were mainly airflow limitation（54.8%） and diffusing capacity decrease（51.6%）.Conclusion The most of patients will have chest symptoms,abnormal lung function and obvious short breath and cough.The impairments of lung function manifest as airflow limitation,decrease of diffusing capacity and increase of RV/TLC%,which commonly are related to activity and severity of UC.The changes of lung function are specific in active stage and in patients with mild or moderate impairment of lung function.