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Pulmonary fibrosis and emphysema: Is the emphysema type associated with the pattern of fibrosis?

World Journal of Radiology 2015年第9期7卷 294-305页

作者： Anastasia Oikonomou Paraskevi Mintzopoulou Argyris Tzouvelekis Petros Zezos George Zacharis Anastasios Koutsopoulos demosthenes bouros Panos Prassopoulos Department of Radiology Democritus University of Thrace Department of Medical Imaging Sunnybrook Health Sciences Centre Department of Pneumonology Democritus University of Thrace Yale School of Medicine Department of Internal Medicine Section of Pulmonary Critical Care and Sleep Medicine Department of Endoscopic Unit Democritus University of Thrace Department of Internal Medicine Division of Gastroenterology Sunnybrook Health Sciences Centre Department of Pathology Democritus University of Thrace Department of Pathology University of Herakleion

AIM: To investigate whether the predominant emphysema type is associated with the high resolution computed tomography(HRCT) pattern of fibrosis in combined pulmonary fibrosis and emphysema(CPFE).METHODS: Fifty-three smokers with upper lobe emphysema and lower lobe pulmonary fibrosis on- HRCT-were retrospectively evaluated. Patients were stratified into 3 groups according to the predominant type of emphysema: Centrilobular(CLE), paraseptal(PSE), CLE = PSE. Patients were also stratified into 3 other groups according to the predominant type of fibrosis on HRCT: Typical usual interstitial pneumonia(UIP), probable UIP and nonspecific interstitial pneumonia(NSIP). HRCTs were scored at 5 predetermined levels for the coarseness of fibrosis(Coarseness), extent of emphysema(emphysema), extent of interstitial lung disease(Tot Ext ILD), extent of reticular pattern not otherwise specified(Ret NOS), extent of ground glass opacity with traction bronchiectasis(extG GOBx), extent of pure ground glass opacity and extent of honeycombing. HRCT mean scores, pulmonary function tests, diffusion capacity(DLCO) and systolic pulmonary arterial pressure were compared among the groups.RESULTS: The predominant type of emphysema was strongly correlated with the predominant type of fibrosis. The centrilobular emphysema group exhibited a significantly higher extent of emphysema(P < 0.001) and a lower extent of interstitial lung disease(P < 0.002), reticular pattern not otherwise specified(P < 0.023), extent of ground glass opacity with traction bronchiectasis(P < 0.002), extent of honeycombing(P < 0.001) and coarseness of fibrosis(P < 0.001) than the paraseptal group. The NSIP group exhibited a significantly higher extent of emphysema(P < 0.05), total lung capacity(P < 0.01) and diffusion capacity(DLCO)(P < 0.05) than the typical UIP group. The typical UIP group exhibited a significantly higher extent of interstitial lung disease, extent of reticular pattern not otherwise specified, extent of ground glass opacity with traction bronchiectasis, e

关键词： Emphysema Pulmonary fibrosis High resolution compu

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胸膜腔内滴注链激酶治疗胸膜腔感染这是胸膜腔积液治疗的进步吗?

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英国医学杂志中文版 2006年第2期9卷 74-75页

作者： demosthenes bouros Katerina M Antoniou Richard W Light 王臻 professor and headDepartment of Pneumonology Medical School Democritus University of Thrace Alexandroupolis Greece research fellow Interstitial Lung Disease UnitImperial College and Royal Brompton HospitalLondon professor and head Pulmonary Disease Program Saint Thomas HospitalNashvilleTN 372USA

由于肺炎旁积液和脓胸的临床表现具有多样性，因此无论在治疗上还是诊断上它们的处理都是临床的难题。胸膜腔感染的临床表现可以从少量的、无并发症、不需特殊处理的单纯胸腔积液，到多房分隔的胸腔积液或脓胸；重者可以伴有胸膜纤维化... 详细信息

由于肺炎旁积液和脓胸的临床表现具有多样性，因此无论在治疗上还是诊断上它们的处理都是临床的难题。胸膜腔感染的临床表现可以从少量的、无并发症、不需特殊处理的单纯胸腔积液，到多房分隔的胸腔积液或脓胸；重者可以伴有胸膜纤维化、肺萎陷、脓毒血症、呼吸衰竭以及远处感染。长久以来，人们一直认为成功治疗胸膜腔感染的关键是胸膜腔脓液引流，

关键词：胸膜腔感染胸膜腔积液治疗胸膜腔内链激酶临床表现胸腔积液肺炎旁积液胸膜纤维化

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