糖皮质激素治疗间质性肺病CT评分和B超b线评分对比

Comparison on CT Scores and B-Ultrasound B-Line Scores in Patients with Interstitial Lung Disease Treated with Glucocorticoid

目的研究糖皮质激素治疗间质性肺病CT评分和B超b线评分情况。方法回顾性分析2017年1月到2018年6月于医院接受检测的糖皮质激素治疗间质性肺病患者40例,以此为实验组,并选取同期医院检测的20例正常者为对照组。其中实验组使用糖皮质激素治疗,比较两组肺活量(VC)、第1秒用力呼气时容积与用力肺活量的比值(FEV1/FVC)、一氧化碳弥散量(DLCO)百分比;分别使用CT和B超b线检测比较两组评分差异;比较实验组使用糖皮质激素治疗前后CT和B超b线检测评分差异。选取两例患者,观察其B超及CT影像结果。结果相比对照组,实验组VC、FEV1/FVC、DLCO水平显著降低,B超b线评分、CT评分显著升高(P<0.05);实验组治疗后较治疗前CT评分、B超b线评分显著降低(P<0.05)。韩某,治疗前肺部明显出现纤维化,大量成纤维细胞聚集、细胞外基质沉积且肺泡结构破坏,b线数量显著升高;何某,治疗后肺部纤维化明显改善,且b线数量显著减少。结论间质性肺病患者CT评分、B超b线评分均有显著改变,且两者对间质性肺疾病的评估具有一致性,呈正相关。

Objective To study scores of CT and B-ultrasound b-line in patients with interstitial lung disease(ILD)treated with glucocorticoid.Methods A retrospective analysis was performed on 40 ILD patients who underwent glucocorticoid treatment in the hospital from January 2017 to June 2018,and they were enrolled as the experimental group.Twenty healthy people who were tested in the hospital during the same period were enrolled as a control group.The experimental group was treated with glucocorticoid.The vital capacity(VC),forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC),and percentage of carbon monoxide diffusing capacity(DLCO)were compared between the two groups.The differences in scores were compared between the two groups by CT and B-ultrasound b-line.The differences in scores detected by CT and B-ultrasound b-line before and after glucocorticoid treatment in experimental groups were compared.Two patients were selected to observe imaging results of B-ultrasound and CT.Results Compared with the control group,VC,FEV1/FVC and DLCO levels were significantly decreased in the experimental group,while B-ultrasound b-line and CT scores were significantly increased(P<0.05).After treatment,scores of CT and B-ultrasound b-line were significantly decreased in the experimental group(P<0.05).There is one patient with pulmonary fibrosis that was significant before treatment.There was a large number of fibroblasts aggregation.The extracellular matrix was deposited,and the alveolar structure was destructed.The number of b-line was significantly increased.After treatment,the patient with pulmonary fibrosis was significantly improved,and the number of b-line was significantly decreased.Conclusion The CT score and B-line B-score of patients with interstitial lung disease have significantly changed,and the two have consistent and positive correlations in the assessment of interstitial lung disease.