长期吸烟者肺小气道损害的功能性HRCT与肺功能测定对照研究

Diseases of the small airways secondary to cigarette smoking:functional HRCT evaluation and correlation with pulomnary function tests

目的 :探讨功能性HRCT及肺功能测定对长期吸烟者肺小气道损害的临床诊断价值。方法 :非吸烟组 2 5例和吸烟组 4 5例 ,行吸气末和呼气末HRCT扫描与肺功能测定 ,并分析其结果。结果 :吸烟组中 30例HRCT表现为小叶中心型肺气肿、全小叶型肺气肿、间隔旁型肺气肿、肺实质微结节、磨玻璃样密度影、小叶间隔线、空气潴留 ;这 30例中肺功能测定正常 2 7例 ,阻塞型通气功能障碍 3例。非吸烟组 19例行肺功能测定 ,结果全部正常 ;HRCT有阳性表现 5例。结论 :吸气末和呼气末HRCT先于肺功能测定发现吸烟对肺小气道的损害。

Objective:To evaluate the value of functional HRCT and PFTs in detecting early stage amall airway diseases secondary to cigarette smoking. Methods:The end-inspiratory and end-expiratory HRCT was performed prospectively in 25 nonsmokers and 45 smokers without any history of pulmonary diseases or present pulmonary symptoms.PFTs were performed in 19 nonsmokers and 30 smokers immediately after obtaining the HRCT scans.The findings of HRCT and results of PFTs were analyzed.Results:The main HRCT findings of the lungs in 30 of the 45 asymptomatic smokers were centrilobular emphysema,panlobular emphysema,paraseptal emphysema,parenchymal micronodules,areas of ground-glass attenuation,thickened interlobular septa and air trapping.The main HRCT findings of the lung in 5 of the 25 nonsmokers were centrilobular emphysema,paraseptal emphysema,thickened interlobular septa and air tapping.PFTs results were within normal ranges in 19 nonsmokers.PFTs results were within normal ranges in 27 of the 30 smokers with the positive apperances of HRCT and abnormal in 3 of ones.Conclusion:The functional HRCT is earlier than PFTs in detecting small airway diseases occurred in asymptomatic smokers.