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目的探讨64排螺旋CT对早期煤工尘肺纤维化定量评分的实用价值。方法用特殊容积软件,对19例0+期煤工尘肺患者的64排螺旋CT胸部平扫图像,进行肺正常密度容积百分比评分,并以肺正常密度容积百分比60%为界分为轻症和重症两组;采集两组患者全肺灌洗治疗后的肺灌洗回收液,用ELISA法检测全肺灌洗回收液中肺泡表面活性蛋白A和D(SP-A、SP-D)含量。结果64排螺旋CT肺正常密度容积百分比与全肺灌洗回收液中SP-D表达水平呈高度显著负相关(r=-0.801,P<0.01)。CT重症组平均累积接尘量(743.2±384.5)mg/m3·y及残气占肺总量百分比(36.5%)均明显高于轻症组(280.7±271.3)mg/m3·y和30.3%,差异有极显著性统计学意义(P(0.01)。结论64排螺旋CT肺正常密度容积百分比测定能对早期煤工尘肺患者的肺纤维化程度进行客观和精确的评估;CT肺纤维化评分与患者全肺灌洗液标志物SP-D表达水平密切相关。
Objective To explore the practical value of 64-slice spiral CT in the quantitative scoring of early coal worker’s pneumoconiosis fibrosis. Methods Totally 19 patients with pneumoconiosis of stage 0 + coal were scanned with 64-slice spiral CT chest CT scans using the special volume software, and the percentage of normal lung volume was scored. The volume of normal lung volume was 60% The lung lavage solution was collected after the whole lung lavage treatment in both groups. The contents of alveolar surfactant protein A and D (SP-A, SP-D) in the whole lung lavage solution were detected by ELISA. Results The percentage of normal lung volume density in 64-slice spiral CT was significantly and negatively correlated with SP-D expression level (r = -0.801, P <0.01). The average accumulated dust exposure (743.2 ± 384.5) mg / m3 · y and the percentage of total residual capacity (36.5%) in CT severe group were significantly higher than those in mild group (280.7 ± 271.3 mg / m3 · y and 30.3% , The difference was statistically significant (P (0.01) .Conclusion The determination of lung normal density volume percentage in 64-slice spiral CT can objectively and accurately evaluate the degree of pulmonary fibrosis in early coal worker’s pneumoconiosis patients. CT pulmonary fibrosis score It is closely related to the level of SP-D expression in patients with pulmonary perfusion fluid marker.