Pneumothorax and idiopathic pulmonary fibrosis
Pneumothorax and idiopathic pulmonary fibrosis
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DOI：
10.1007/s11604-010-0494-1
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发表时间：
2010-11-01
影响因子：
2.1
通讯作者：
Inoue, Tomio
中科院分区：
文献类型：
--
作者：
Iwasawa, Tae;Ogura, Takashi;Inoue, Tomio
我们评估了特发性肺纤维化（IPF）的严重程度与计算机断层扫描（CT）图像上气胸的发生率之间的关系。在这项回顾性研究中，我们评估了56例连续死于IPF的患者从最初的CT到死亡期间是否存在气胸。我们对207张CT图像进行了定量分析，并测量了初始CT上正常模式（n -模式）和各病变模式的体积及其序列变化。采用Cox回归分析评估气胸、临床及CT表现对生存率的影响。56例患者中有17例发生气胸。气胸（+）组与气胸（-）组比较，前者初始肺活量（VC）较低（P = 0.005），随访时间较短（P = 0.03）。气胸（+）组n型体积下降明显快于气胸（-）组（P = 0.013）。Cox回归分析发现n型体积快速下降（P = 0.008）和VC快速下降（P = 0.002），但气胸不是生存不良的重要预测因素。IPF患者的气胸与较低的VC和CT表现的迅速恶化有关。结果提示气胸是晚期IPF的并发症。
We evaluated the relation between the severity of idiopathic pulmonary fibrosis (IPF) and the incidence of pneumothorax on computed tomography (CT) images.In this retrospective study, we evaluated the presence of pneumothorax in 56 consecutive patients who died of IPF from the initial CT to death. We quantitatively analyzed a total of 207 CT images and measured the volume of the normal pattern (N-pattern) and each lesion pattern on the initial CT and their serial changes. The effects of pneumothorax and clinical and CT features on survival were evaluated using Cox regression analysis.Pneumothorax occurred in 17 of 56 patients. Comparison of the pneumothorax (+) and (-) groups showed the initial vital capacity (VC) was lower (P = 0.005) and the follow-up period was shorter (P = 0.03) in the former group. The decrease in the N-pattern volume in the pneumothorax(+) group was significantly faster than in the pneumothorax(-) group (P = 0.013). Cox regression analyses identified a rapid decrease in N-pattern volume (P = 0.008) and a rapid decrease in VC (P = 0.002), but not pneumothorax, as significant predictors of poor survival.Pneumothorax in IPF patients is associated with lower VC and rapid deterioration of CT findings. The findings suggest that pneumothorax is a complication of advanced IPF.