الفهرس | Only 14 pages are availabe for public view |
Abstract Smoking remains the principal risk factor for developing lung diseases by damaging the airways and the alveoli. Lung diseases caused by smoking include COPD, which includes emphysema and chronic bronchitis and causes most cases of lung cancer and some forms of ILDs and is a leading cause of death worldwide. With the increasing use of computed tomography (CT) in clinical practice and lung cancer screening, there is a growing interest in the added value of CT for the diagnosis of smoking related comorbidities, in particular coronary artery disease and chronic obstructive pulmonary disease. In this regard, there is a need for reliable computed tomography, especially HRCT (high resolution computed tomography) as it is the method of choice for visualizing pulmonary morphology and is an established method in the diagnosis and follow-up of emphysema. Thickening of the airway walls in cigarette smokers is thought to be due to a combination of inflammatory changes and remodeling. Airway measurements on CT are often expressed as airway wall thickness or luminal area of specific segmental and sub-segmental bronchi. This study aimed to detect pulmonary changes among a-symptomatic smokers using high- resolution computed tomography scan and pulmonary function test (PFT). A prospective observational study was conducted on two groups of asymptomatic smokers and 20 matched healthy no smokers serving as a control group. Summary 70 The studied patients were included 120 subjects classified into: group I: consisted of 80 of adult smokers who are healthy and had no history of respiratory disease. group II: (Control group) consisted of 40 apparently healthy volunteers of comparable age and sex. Inclusion criteria: Average number of adult smokers who are healthy and had no history of respiratory disease. Exclusion criteria: Smokers who have any chest disease, no smoker who have any various disorders (psychiatric disorder, lymphoma, sequelae due to coronary bypass operation). For every patient the following was done: Full history taking: including Personal history including (sex, age, occupation and residence). Clinical examination: General and local chest examination. Spirometry in the form of FVC, FEV1, FEV1/FVC, FEF25-75, PEF. Radiological investigation: Chest x-ray posteroanterior view and HRCT of the chest is performed Prone position, Dynamic film (inspiratory and expiratory) and findings are reported by radiologist to detect of pulmonary changes. Results of the current study could be summarized that: There were significant differences between cases and control regarding inspiratory and expiratory HRCT among cases. Abnormal inspiratory HRCT was 45% while abnormal expiratory HRCT was 68.8%. There were significant differences between cases and controls regarding emphysematous changes, bronchial thicking and sub pleural lines. Summary 71 Emphysematous changes, bronchial thicking and sub pleural lines were represented 27.5%, 12.5%, 12.5%, respectively among cases. There was statistically significant difference between inspiratory and expiratory air trapping in cases. Air trapping were present in 4% while expiratory air trapping were present in 18%. There was no statistically significant difference between cases and control groups regarding FVC, FEF 25-75 and FEV1/FVC. There was no significant difference between different types of smoking index (mild, moderate, severe) regarding inspiratory HRCT, expiratory HRCT and pulmonary function test. There was statistically significant difference between abnormal and normal HRCT regarding pulmonary function test. |