高分辨CT在特发性肺间质纤维化患者中的应用及HRCT评分与预后生活质量的相关性分析

Application of high resolution CT in patients with idiopathic pulmonary fibrosis and the correlation between HRCT score and prognosis quality of life

目的探讨高分辨CT(HRCT)在特发性肺间质纤维化(IPF)患者中的应用及HRCT评分与预后生活质量的相关性。方法回顾性分析我院收治的80例IPF患者临床资料,所有患者均行HRCT与普通CT扫描,根据HRCT影像评分结果将其分为A、B、C、D四组(HRCT4分,3分,2分,1分;n=14,27,30,9),随访至检查后6个月,分析四组患者生活质量[特发性肺间质纤维化患者反馈结局量表(IPF-PRO)]差异,采用Pearson相关性分析法分析IPF患者HRCT评分与IPF-PRO评分相关性。结果 HRCT检出小叶间隔不规则增厚、支气管扩张、小叶性肺气肿及胸膜下线征象比例均明显高于普通CT(P均<0.05)。四组IPFPRO评分比较A组>B组>C组>D组,差异均有统计学意义(P均<0.05)。Pearson相关分析表明,IPF患者HRCT评分与检查后6个月时IPF-PRO评分呈正相关(r=0.839,P=0.000)。结论 HRCT可清晰呈现IPF患者肺部纤维灶征象,且HRCT评分与其预后生活质量正相关性明显,有利于IPF临床诊断与预后评估。

Objective To explore the application of high resolution CT（HRCT） in patients with idiopathic pulmonary fibrosis（IPF） and the correlation between HRCT score and prognosis quality of life. Methods The clinical data of 80 patients with idiopathic pulmonary fibrosis in our hospital were analyzed retrospectively. HRCT and common CT scans were performed in all patients. According to the HRCT image grading results, they were divided into four groups： group A, B, C and D（HRCT score： 4 points, 3 points, 2 points, 1 point, n=14, 27, 30, 9）. Follow up to 6 months after the examination, the quality of life of four groups of patients [idiopathic pulmonary fibrosis patients＇ feedback Outcome Scale（IPF-PRO）] was analyzed. Pearson correlation analysis was used to analyze the correlation between HRCT score and IPF-PRO score in IPF patients. Results The proportions of irregular thickening, bronchiectasis, lobular emphysema and pleural line were significantly higher in HRCT than in normal CT（P〈0.05）. The IPF-PRO scores of the four groups were compared with group A 〉group B 〉group C〉 group D, and the differences were statistically significant（P〈0.05）. Pearson correlation analysis showed that the HRCT score of IPF patients was positively correlated with the IPF-PRO score at 6 months after the examination（r=0.839, P=0.000）. Conclusion HRCT can clearly show the signs of pulmonary fibrosis in patients with IPF, and the HRCT score has a positive correlation with the quality of life of the prognosis, which is beneficial to the clinical diagnosis and prognosis evaluation of IPF.