·糖尿病临床研究·

　　【摘要】目的 探讨T2DM患者胸部CT表现及随访肺内病变变化情况与临床的关系。方法 回顾性观察60例T2DM患者胸部CT图像，分析各种病变的分布特征。用CT视觉评分方法定量分析肺内病变，并与CT复查图像进行对照，分析肺内病变变化特征与临床的关系。结果 60例T2DM患者中胸部CT表现正常9例(15%)、磨玻璃样影31例(52%)、小叶间隔增厚32例(53%)、显著多于胸膜下线8例(13%)、支气管血管束增厚3例(5%)、小叶内间质增厚3例(5%)等病变(χ2=76.979，P<0.01)。肺内病变分布具有周围分布、下肺分布为主的特点。复查后仅14例磨玻璃样病变有不同程度吸收，与未吸收组相比，磨玻璃样病变吸收组的病程较短(t=2.485，P=0.023)，HbA1c较低(U=2.831，P=0.015)。结论 CT及其随访检查的半定量分析肺内病变，对评估糖尿病肺损害的短期变化及与临床的关系有一定价值。

　　【关键词】糖尿病，2型;体层摄影术;X线计算机;糖化血红蛋白;随访研究

The chest CT findings in patients with T2DM and short-term follow-up studies CHEN Yi-lei, ZhANG Min-guang. Department of Radiology, Municipal TCM Hospital Affiliated to Shanghai University of Chinese Medicine, Shanghai 200071, China

Corresponding author: ZHANG Min-guang, E-mail: mgzhang09@163.com

　　【Abstract】Objective To investigate the chest CT findings and follow-up the relationship between changing conditions of lung lesions and clinical data of T2DM patients. Methods Images of chest CT scans in 60 T2DM patients were retrospectively observed. The distribution characteristics of lung lesions were analyzed. CT visual score was used for quantitatively analyzing the lung lesions, which were compared with the CT recheck images. The relationship between the changing characteristics of lung lesions and clinical manifestations was analyzed. Results Of the 60 T2DM patients, 9 (15%) had normal CT shows, 31 (52%) had ground-glass opacity, 32 (53%) had interlobular septal thickening, 8 (13%) had subpleural bands, 3 (5%) had bronchovascular bundle thickening, and 3 (5%) had intralobular interstitial thickening, (χ2=76.979, P<0.01). The lesion distribution was characterized by in peripheral and lower lung fields. The follow-up showed that only 14 patients with ground-glass opacity lesion had absorption of lesion to different degrees. Compared with the group with non-absorption of ground-glass opacity lesion, the disease course of the group with absorption was shorter (t=2.485, P=0.023) and HbA1c level was lower (U=2.831, P=0.015). Conclusion CT scanning and half quantitative analysis on the lung lesions in follow-up examinations are useful for evaluating the short-term changes of diabetic lung damages and observing their relationship with the clinical manifestations.

　　【Key word】 Diabetes mellitus, type 2; Tomography; X-ray computer; Hemoglobin A1c (HbA1c); Follow-up studies