超敏性肺炎的高分辨率计算机断层扫描结果及相关因素的评价

A. Koyuncu, H. Ertürk
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引用次数: 0

摘要

背景/目的:过敏性肺炎(Hypersensitivity pneumonitis, HP)是一种由吸入多种环境和职业性有机物质引起的肺部疾病,如真菌、细菌、鸟类,偶尔也有非有机物质。免疫反应会引发这种情况。高分辨率胸部计算机断层扫描(HRCT)通常作为初始诊断评估的一部分进行。本研究评估了HP患者的HRCT表现,并检查了纤维化和非纤维化患者组之间的相关因素。方法:这项回顾性横断面研究包括2010年至2022年间监测的所有HP患者。该分析包括117名患者的数据。患者的HRCT结果根据纤维化的存在进行分类,将患者分为纤维化组和非纤维化组。对两组进行比较分析。结果117例患者中,男性59例(50.4%),女性58例(49.6%)。平均诊断年龄为52.1(13.6)岁,年龄范围为20 ~ 81岁。非纤维化HP组70例(59.8%),纤维化HP组47例(40.2%)。最常见的HRCT表现为毛玻璃混浊(90.6%)、马赛克衰减(87.2%)和牵引支气管扩张(50.4%)。非纤维化HP组和纤维化HP组在HRCT表现方面存在统计学差异:毛玻璃样混浊、不规则线状混浊、网状、牵引支气管扩张、蜂窝状和纤维化(P=0.024, P<0.001)。非纤维化HP组支气管肺泡灌洗液淋巴细胞比为28.78(16.2),纤维化HP组淋巴细胞比为14.66(10.3)。纤维化HP组支气管肺泡灌洗液淋巴细胞比例明显降低(P<0.001)。结论:HRCT表现是HP诊断和分型的关键。计算机断层扫描也有助于描述HP的分类。本研究发现,HP患者HRCT最常见的表现为毛玻璃影和马赛克衰减。研究纤维化与预后之间的关系对于确定患者预后至关重要,因为纤维化似乎是主要决定因素。
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Evaluation of high-resolution computed tomography findings and associated factors in hypersensitivity pneumonitis
Background/Aim: Hypersensitivity pneumonitis (HP) is a lung disease from inhaling diverse environmental and occupational organic substances, such as fungi, bacteria, birds, and occasionally nonorganic materials. An immune response triggers this condition. A high-resolution chest computed tomography (HRCT) scan is typically performed as part of the initial diagnostic assessment. This study assesses HRCT findings in HP patients and examines associated factors between fibrotic and non-fibrotic patient groups. Methods: This retrospective cross-sectional study encompassed all HP patients monitored between 2010 and 2022. The analysis included data from 117 patients. HRCT findings from the patients were categorized based on fibrosis presence, leading to the division of patients into fibrotic and non-fibrotic groups. Comparative analyses were conducted between these groups. Results: Among the 117 subjects analyzed, 59 (50.4%) were male, and 58 (49.6%) were female. The mean age at diagnosis was 52.1 (13.6) years, ranging from 20 to 81. The non-fibrotic HP group comprised 70 (59.8%) patients, while the fibrotic HP group comprised 47 (40.2%). The most prevalent HRCT findings were ground-glass opacity (90.6%), mosaic attenuation (87.2%), and traction bronchiectasis (50.4%). Statistically significant disparities were observed between non-fibrotic and fibrotic HP groups in terms of HRCT findings: ground-glass opacity, irregular linear opacities, reticulation, traction bronchiectasis, honeycombing, and fibrosis (P=0.024, P<0.001). In contrast, the lymphocyte ratio in bronchoalveolar lavage fluid was 28.78 (16.2) in the non-fibrotic HP group and 14.66 (10.3) in the fibrotic HP group. The fibrotic HP group exhibited a statistically significant lower lymphocyte ratio in bronchoalveolar lavage fluid (P<0.001). Conclusion: HRCT findings are pivotal in HP diagnosis and classification. Computed tomography also assists in delineating the HP classification. This study identified ground-glass opacity and mosaic attenuation as the most prevalent HRCT findings in HP patients. Investigating the connection between fibrosis and prognosis is vital for determining patient outcomes, as fibrosis appears to be the principal determinant.
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