Objective To compare clinical features,pulmonary functions,
chest imaging and
prognosis between combined
pulmonary fibrosis and
emphysema syndrome (CPFE) and
idiopathic pulmonary fibrosis(IPF) without emphysematous changes in
elderly patients.
Methods 88
elderly IPF
patients in
Beijing hospital from January 2000 to October 2012 were divided into CPFE (n=30) and IPF (n =58) groups according to the CT imaging.Clinical features,
blood gas analysis,pulmonary function,
chest CT and
survival time were compared between the two groups.Results 30 CPFE
patients with the mean age of(75.5 ±7.6) years and 58 IPF
patients without
emphysema with the mean age of(73.7±6.8) years were enrolled.The proportions of
male patients,
smoking history and
mortality were higher in CPFE
patients than in IPF group(86.7% vs.63.8%,28 vs.36,76.7% vs.43.1%,x2 =5.09,9.74,8.98,P<0.05 or 0.01).CPFE
patients had a higher force
vital capacity(FVC) and
total lung capacity(TLC) as compared with IPF group [(2.6±0.9) L vs.(2.1± 0.5) L,(5.4±1.9) L vs.(4.4±1.1) L,t=2.69,2.35,P<0.01 or 0.05].There were no significant differences in
forced expiratory volume in one second(FEV1) and the
diffusion capacity for
carbon monoxide(DLCO) between the two groups.The main type of
emphysema by HRCT scan were
centrilobular emphysema in CPFE
patients.There were lower median
survival time in CPFE group than in IPF group [(3.0±0.2) years vs.(4.0±1.0) years,x2=4.50,P<0.05].Conclusions The majority of
elderly CPFE
patients are
males and
smokers.The
lung volume is increased in
elderly CPFE
patients as compared with IPF
patients.
Centrilobular emphysema is the primary type in CPFE
patients.The
prognosis is worse in
elderly CPFE
patients than in IPF
patients.