溃疡性结肠炎肺功能损害和肺与大肠的表里关联性

作者	单位
张雯	北京中医药大学东直门医院消化科
吴健	北京中医药大学东直门医院消化科
王新月	北京中医药大学东直门医院消化科
王建云	北京中医药大学东直门医院消化科
孙慧怡	北京中医药大学东直门医院消化科
刘大铭	北京中医药大学东直门医院消化科

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中文摘要:

目的观察溃疡性结肠炎(ulcerative colitis,UC)患者发生肺功能损害的机率及肺功能损害的特点,并初步探讨其与病情严重程度的相关性,进而分析肺与大肠的表里关系。方法 70例UC患者,按病情程度分为轻度、中重度两组(每组35例),30名健康人作为健康对照组,观察各组肺功能的相关指标,并进行比较。结果 47例(67.14%)UC患者发生肺损害;UC患者第一秒用力呼气量占用力肺活量的百分率(forced expiratory volume at1st s/forced volume capacity,FEV1/FVC),75%用力肺活量时呼气流速(maximalexpiratory flowin 75% vital capacity,FEF75),肺总量(total lung capacity,TLC),一氧化碳弥散量(diffusion ca-pacity for carbon monoxide of lung,DLCO),肺一氧化碳弥散量/肺泡通气量(diffusion capacity for carbon monox-ide of lung/alveolar ventilation,DLCO/VA)低于健康组,差异有统计学意义(P<0.05);残气容积与肺总量之比(residual volume/total lung capacity,RV/TLC)轻度组低于中重度组(P<0.01),DLCO轻度组高于中重度组(P<0.05)。结论溃疡性结肠炎患者多伴有肺功能的损伤,以中小气道阻塞、弥散量下降为主要特征,且随病情的加重,出现弥散量下降、残气量比肺总量升高。为肺与大肠相表里的中医学理论提供客观依据。

英文摘要:

Objective To observe the probability of the lung injury and the features of the lung function injury in ulcerative colitis patients,and to preliminarily study the correlation with its severity,and further to analyze the interior-exterior correlation between Fei and Dachang. Methods Seventy patients with UC were assigned to the mild group and the moderate-severe group by the severity,35 cases in each group. Another thirty healthy subjects were recruited as the control group. Relative indices of the lung function in each group were observed and compared. Results The lung injury occurred in 67.14% of the UC patients (47 cases). Forced expiratory volume at 1st s/forced volume capacity (FEV1/FVC),maximal expiratory flow in 75% vital capacity (FEF75),total lung capacity (TLC),diffusion capacity for carbon monoxide of lung (DLCO),and diffusion capacity for carbon monoxide of lung/alveolar ventilation (DLCO/VA) were lower compared with those of the control group,showing statistical significance (P<0.05). The ratio of residual volume/total lung capacity (RV/TLC) was lower in the mild group than in the moderate-severe group (P<0.01). The DLCO was higher in the mild group than in the moderate-severe group (P<0.05). Conclusions Most UC patients were complicated with the lung function injury,mainly featured as middle and small airway obstruction and decreasing diffusing capacity. Besides,along with the aggravation of the disease,the decreasing diffusing capacity and increasing RV/TLC occurred. They provided objective reliance for Fei and Dachang interior-exteriorly correlated.

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