Eur Radiol:慢性过敏性肺炎患者CT表现的动态变化预测纤维化进展及急性加重

2021-01-05 shaosai MedSci原创

慢性过敏性肺炎患者CT表现的动态变化预测纤维化进展及急性加重

目的:评价慢性过敏性肺炎(HP)患者胸部CT表现的纵向变化,并确定纤维化进展和急性加重(AE)的危险因素。

方法:本项回顾性研究纳入了有CT随访的慢性HP患者。对基线信息和连续随访的CT图像进行了半定量评估。 纤维化评分定义为网状和蜂窝状区域的总和。同时评价了Fleischner Society特发性肺纤维化诊断指南的改良CT特征。 进行Cox比例风险回归以确定与纤维化进展和AE相关的重要变量。

结果:本研究共纳入的91名患者中,平均年龄为59.1岁,女性为61.5%。 中位随访期为4.9年。79名患者(86.8%)显示出纤维化进展,表现为“马赛克”区域的持续存在并最后被纤维化所替代,其中20名(22.0%)发展为AE。在调整临床协变量后,基线纤维化评分和寻常型间质性肺炎(UIP)/可能的UIP的CT特征是预测纤维化进展(危险比[HR] = 1.05,95%置信区间[CI] = 1.02-1.09,p <0.001, 纤维化评分; HR = 2.50,CI = 1.50-4.16,p <0.001,CT特征)和AEs(HR = 1.07,CI = 1.01-1.13,p = 0.019,纤维化评分; HR = 5.47,CI = 1.23-24.45,p = 0.026,CT特征)的独立危险因素。

结论:在慢性HP患者中,纤维化进展和AE占86.8%和22.0%。基线时胸部CT上的UIP /可能的UIP的纤维化评分和CT特征可预测纤维化进展和AE。

原始出处:

Jooae Choe,Eun Jin Chae,Yeon Joo Kim,et al. Serial changes of CT findings in patients with chronic hypersensitivity pneumonitis: imaging trajectories and predictors of fibrotic progression and acute exacerbation. PMID:33241510DOI:10.1007/s00330-020-07469-2

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    2021-01-05 Jessie Zhang

    慢性过敏性肺炎患者CT表现的动态变化预测纤维化进展及急性加重

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