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目的应用薄层螺旋高分辨率CT(HRCT)评价无临床症状人群肺老化的各项影像学征象,分析其与被检查者年龄的相关性,探讨其临床诊断应用价值。方法应用薄层螺旋HRCT对106名无胸部疾病及临床症状者[分30～44岁(31例)、45～59岁(30例)和60岁以上(45例)3个年龄组]进行肺上中下野3个区域的高分辨CT扫描,观察肺间质性改变、肺气肿样改变、马赛克样灌注、肺叶密度梯度差异和胸膜肥厚5项征象,按照标准化评分系统进行评分,再应用SPSS软件对各个指标进行统计学分析。结果在3个年龄组中,肺间质性改变、肺气肿样改变和马赛克样灌注组间差异有统计学意义(χ2值分别为8.10、9.73和15.54,P值均<0.01);而肺叶密度梯度和胸膜肥厚差异无统计学意义(χ2值分别为3.66和3.24,P值均>0.05)。根据各征象的评价标准计算出的积分值与研究对象的年龄呈高度正相关(r=0.709,P<0.01)。结论无胸部疾病临床症状者HRCT可见肺间质性改变、肺气肿、马赛克样灌注、肺叶密度梯度差异和胸膜肥厚等结构改变,这些改变随年龄增长而增加。HRCT是评价早期肺老化的重要手段之一。
Objective To evaluate the imaging features of pulmonary aging in patients without clinical symptoms by thin-slice spiral high-resolution CT (HRCT), analyze its correlation with the age of the subjects and explore its clinical value. Methods Sixty patients without thoracic disease and clinical symptoms [31 to 30 years old, 45 to 59 years old (30 cases) and 45 years old over 45 years old] were treated with thin-slice helical HRCT for lung High-resolution CT scan in three regions of the upper and lower middle and upper back, observing five signs of pulmonary interstitial changes, emphysema-like changes, mosaic-like perfusion, lobar density gradient and pleural hypertrophy, according to the standardized scoring system, and then SPSS Software for all indicators of statistical analysis. Results Among the three age groups, there were significant differences in interstitial lung changes, emphysema-like changes and mosaic-like perfusion group (χ2 = 8.10, 9.73 and 15.54, P <0.01) There was no significant difference in density gradient and pleural hypertrophy between the two groups (χ2 = 3.66 and 3.24, P> 0.05). The integrated value calculated according to the evaluation criteria of each symptom was highly positively correlated with the age of the subjects (r = 0.709, P <0.01). Conclusion The clinical manifestations of non-chest diseases HRCT can be seen interstitial lung changes, emphysema, mosaic-like perfusion, density gradient lobe and pleural thickening and other structural changes, these changes increase with age. HRCT evaluation of early lung aging is one of the important ways.