【摘要】：目的 1.分析肺纖維化合并肺氣腫(CPFE)綜合征患者的一般資料、臨床表現(xiàn)及體征、肺功能、肺動脈壓、肺癌標志物、CT表現(xiàn)及預后等臨床資料,為臨床診斷及治療提供參考。 2.通過對相關文獻的系統(tǒng)復習,綜合分析近十年來國內(nèi)外對肺氣腫合并肺纖維化綜合征的認識。 方法 1.收集山東省千佛山醫(yī)院2010年1月到2012年12月診斷的7例CPFE綜合征的患者。 2.分析所收集患者的一般資料、臨床表現(xiàn)及體征、肺功能、肺動脈壓力、肺癌標志物及CT表現(xiàn)。 3.結合臨床文獻分析進行歸納、總結肺纖維化合并肺氣腫(CPFE)綜合征的臨床特點。 結果 1.7例患者中6例為男性,1例為女性,年齡62-84歲,中位年齡77.4歲；6例有吸煙史,其中有1例從事酒渣運輸工作40余年。全部病例均有活動后呼吸困難,雙下肺均可聞及吸氣相VelcroUp音。 2.肺功能結果[中位數(shù)(范圍)]：FEVl%pred平均為73%(39%～98%),FVC%pred平均為73%(54%～101%),FEV1/FVC%平均為81%(61%～96%),VC%pred平均為79%(57%～86%),TLC%pred平均為85%(53%～110%),RV/TLC%平均為41%(21%～58%)。DLco%pred平均為46%(20%～58%),DLco/VA%平均為53%(19%～98%)。 3.有4例有肺動脈高壓,平均為45mmHg(32mmHg～69mmHg)。肺癌標志物中有2例出現(xiàn)NSE升高。 4.胸部CT可見雙上肺肺氣腫及雙下肺磨玻璃樣、網(wǎng)格狀、蜂窩樣及牽拉性支氣管擴張的肺纖維化表現(xiàn)。 結論 1. CPFE綜合征患者好發(fā)于男性有吸煙史的患者。 2.臨床特征包括呼吸困難、低氧血癥、肺動脈高壓。 3.肺功能表現(xiàn)為肺容積相對正常而彌散能力顯著下降。 4.高分辨率CT的特點為同時存在上肺野肺氣腫和下肺野纖維化。 5.其常見并發(fā)癥為肺動脈高壓、急性肺損傷、肺癌。
[Abstract]:Objective 1. To analyze the general data, clinical manifestations and signs, pulmonary function, pulmonary artery pressure, lung cancer markers, CT manifestations and prognosis in patients with pulmonary fibrosis complicated with emphysema (CPFE) syndrome, and to provide reference for clinical diagnosis and treatment. 2. Based on the systematic review of related literature, the understanding of emphysema complicated with pulmonary fibrosis syndrome in recent ten years was analyzed. Method 1. A total of 7 patients with CPFE syndrome diagnosed from January 2010 to December 2012 in Qianfushan Hospital of Shandong Province were collected. The general data, clinical manifestations and signs, pulmonary function, pulmonary artery pressure, lung cancer markers and CT findings were analyzed. The clinical features of pulmonary fibrosis combined with emphysema (CPFE) syndrome were summarized. Results among the 1.7 patients, 6 were male and 1 female, aged from 62 to 84 years, with a median age of 77.4 years, and 6 cases had a history of smoking, of which 1 case was engaged in the transport of wine residue for more than 40 years. All of the patients had dyspnea after movement, and both lower lungs could hear and inhale VelcroUp 2. 2. 鑲哄姛鑳界粨鏋淸涓綅鏁，

本文編號：2276227