中文摘要：

目的探讨放疗前单光子发射型计算机断层扫描（SPECT）肺血流灌注显像联合肺功能检查（RFTs）筛选发生放射性肺炎（RP）高危人群的价值。方法前瞻性入组57例接受根治性三维适形或调强放疗的Ⅲ期非小细胞肺癌患者，治疗结束后随访观察，采用NCICTC3．0标准对RP进行分级。所有患者放疗前行SPECT肺灌注扫描和RFT8以评价基础肺功能。分析肺功能损伤与发生RP风险的相关性。结果RP组肺通气功能参数有下降趋势，但没有达到具有统计学意义的程度（P值范围0．111—0．854），然而当患者放疗前用力肺活量（FVC）≤2．4L或第1秒用力呼气容积（FEV1.0）≤1．8L或平均用力呼气流量（FEF25%-75%）≤2．0L／s时发生RP的概率显著增加，具有统计学意义（P=0．017，0．026，0．042）。FVC是RP发生的独立影响因素（曰=3．045，P=O．027），但是FVC与FEV1．0、FEF25%-75%之间均具有共线性（r=0．843，0．600，P均〈0．001）。结论放疗前行肺功能检查评价患者基础肺功能，对筛选发生RP高危人群具有重要的临床价值。

英文摘要：

Objective To investigate the value for screening high-risk population of radiation pneumonitis （RP）with single-photon emission computed tomography（SPECT） lung peffusion combining respiratory function tests （RFTs） before radiation therapy （RT）. Methods A total of 57 cases with stageIII non-small cell lung cancer （NSCLC） patients treated with radical three dimensional conformal or intensity-modulated radiotherapy were recruited and followed-up prospectively. The grade of RP was evaluated according to the NCI Common Terminology Criteria for Adverse Events （ version 3.0 ）. All patients performed with SPECT lung peffusion and RFFs before RT to evaluate the base-line lung function. The correlation among the base-line lung function and RP occmrrence was analyzed. Results Although parameters for RFTs trend to decline in RP group, there was no statistical significance observed （ P value 0. 111-0. 854 ）, however, if patient with FVC ≤ 2.4 L or FEV1.0 ≤1.8 L or FEF25%-75%≤2. 0 L/s before RT, the probability of RP occurrence was increased significantly （ P = O. 017,0. 026,0. 042, respectively ）. FVC was an independent risk factor（ B = 3.045, P = O. 027 ） associated with RP, but colinearity with FEV1.0, and FEF25%-75%（ Pearson r = 0. 843, O. 600, respectively, P 〈 0. 001 ）. Conclusions Base-line lung function tests before RT is important for screening high-risk population of radiation pneumonitis.