【摘要】 目的研究特发性间质性肺炎(IIP)患者肺泡毛细血管膜弥散能力(DM)和肺泡毛细血管床容量(VC)变化及特点。方法20例IIP患者作为观察组,包括寻常性间质性肺炎(UIP)及非特异性间质性肺炎(NSIP)各7例。24例健康志愿者为对照组。测定观察组及对照组的CO弥散量(DLCO)、比弥散量(DLCO/VA)、DM、VC及肺通气功能。结果观察组及对照组的FEV1分别为(72.44±13.61)%及(103.33±11.96)%(预计值),FVC为(74.80±20.59)%及(116.08±16.84)%(预计值),观察组均明显降低(P<0.001);FEV1/FVC分别为(80.00±7.99)%、(79.92±4.56)%,无显著性差异(P>0.05);DLCO分别为(13.64±4.20)mL·mmHg1·min1及(21.80±2.88)mL·mmHg1·min1,观察组明显降低(P<0.001);DLCO/VA分别为(4.49±1.16)mL·mmHg1·min1、(4.23±0.57)mL·mmHg1·min1,无显著性差异(P>0.05);DM分别为(30.17±19.61)mL·mmHg1·min1、(67.63±11.28)mL·mmHg1·min1,VC分别为(51.00±13.06)mL、(66.67±9.62)mL,观察组均明显降低(P<0.001,P<0.05)。UIP组与NSIP组上述参数均无显著性差异(P>0.05)。结论DLCO变化可由DM和VC变化共同影响。DM、VC变化也可不完全一致,DM降低时VC可正常甚至反而升高,DLCO却可能在正常范围。DM及VC测定可作为早期评价肺弥散功能损害敏感而有效的方法。更多还原

【Abstract】 Objective To investigate diffusion capacity of pulmonary capillary membrane and pulmonary capillary volume in patients with idiopathic interstitial pneumonia（IIP）.Methods Twenty patients with IIP were enrolled.IIP patients included 7 cases for both usual interstitial pneumonia（UIP）and NSIP respectively.Twenty-four healthy subjects matched by age and gender were enrolled as control.D_LCO,D_LCO/V_A,D_M,V_C and spirometry were measured.Results [JP2]Spirometry test revealed that FEV₁ were （72.44±13.61） % and （103.33±11.96）%,and FVC were （74.80±20.59） % and （116.08±16.84）%p in IIP patients and controls,respectively（P<0.001）.On the other hand,FEV₁/FVC was （80.00±7.99）% in IIP and （79.92±4.56）% in controls and no significant difference was found（P> 0.05）.D_LCO were （13.64±4.20） mL·mm Hg -1·min -1 in IIP patients and （21.80±2.88）mL·mm Hg -1·min -1 in controls with a significant decrease in IIP patinents （P<0.001）.However,D_LCO/V_A was （4.49±1.16） mL·mm Hg -1·min -1 in IIP patients and （4.23±0.57） mL·mm Hg -1·min -1[JP] in controls and no significant difference was found（P> 0.05）.D_M was （30.17±19.61） mL·mm Hg -1·min -1 in IIP and （67.63±11.28） mL·mm Hg -1·min -1 in contols;V_C was （ 51.00±13.06）mL in IIP and （66.67± 9.62）mL in controls respectively,whih significant decline in IIP （P<0.001,P< 0.05,respectively）.No differences in those parameters were found between UIP and NSIP patients（P> 0.05）.Conclusions Both D_M and V_C contribute to the variation of D_LCO.However,D_M and V_C may change inconsistently,ie,V_C may be normal or increased when D_M decline resulting a relative normal D_LCO.D_M and V_C may be applied as sensitive tools for detection of diffusion capacity of IIP patients at early stage.更多还原