骨髓增生异常综合征患者肺功能的临床研究

摘要

Objective To explore the pulmonary function of patients with myelodysplastic syndrome (MDS) and analyze it after hematopoietic stem cells transplantation(HSCT). Methods Fifty patients with MDS were experiment group chosen from January 2013 to October 2017 in Navy General Hospital,and 50 healthy cases were control group during the same period. All spirometric values were recorded including percentage predicted forced vital capacity (FVC),forced expiratory volume in one second(FEV1),vital capacity(VC),residual volume(RV),peak expiratory flow (PEF),maximal mid-expiratory flow (MMEF), and diffusing capacity of the lung for carbon mon-oxide (DLCO). To compare the lung function before and after HSCT during 6-12 months of 15 MDS patients who had accepted HSCT therapy.Results Patients in experimental group experienced a significant decrease in the predict percent of FVC,FEV1,VC,PEF,MMEF,DLCO,which were significantly different compared with those in control group (P<0.05). The predict percent of RV was increased,but no statistic difference. There were negative relationship between lung function, duration of diseases,lung infection frequency, and combined chemotherapy. After HSCT, the spi-rometric of MDS patients such as the predict percent of FVC, FEV1, VC, PEF, MMEF, DLCO were significantly decreased (P<0.01), compared with before transplantation. Conclusion The ventilatory function, small airway function and diffusion function of patients with MDS were dam-aged. Indices of lung function had negative relation with diseases duration,lung infection frequency, and combined chemotherapy. After HSCT,damages of above indices were aggravated.%目的 探讨骨髓增生异常综合征(myelodysplastic syndrome,MDS)患者肺功能情况,分析MDS患者行异体造血干细胞移植术后肺功能的变化.方法 选取海军总医院2013年1月-2017年10月收治的50例MDS患者为观察组,同期健康体检者50例为对照组,回顾性比较2组患者用力肺活量(forced vital capaci-ty,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、肺活量(vital capacity,VC)、残气容积(residual volume,RV)、最大呼气流量(peak expiratory flow,PEF)、最大呼气中期流量(maximal mid-expira-tory flow,MMEF)、肺一氧化碳弥散量(diffusing capacity of the lung for carbon monoxide,DLCO)占预计值百分比等各项肺功能指标的差异.15例MDS患者行异体造血干细胞移植治疗,比较移植前与移植后6~12月内肺功能的变化.结果 观察组患者FVC、FEV1、VC、PEF、MMEF、DLCO占预计值百分比降低,与对照组相比差异有统计学意义(P<0.05),RV占预计值百分比增高,但差异无统计学意义.肺功能指标特别是通气功能指标与患者患病时程、肺部感染次数和联合化疗呈负相关.MDS患者行异体造血干细胞移植术后FVC、FEV1、VC、PEF、MMEF、DLCO占预计值百分比较移植前降低(P<0.01).结论 MDS患者肺通气功能、小气道功能和弥散功能均受损害,肺功能指标与患者患病时程、肺部感染次数和联合化疗呈负相关.患者行异体造血干细胞移植术后通气功能、小气道功能和弥散功能受损加重.