摘要
目的研究慢性阻塞性肺疾病(COPD)患者肺气肿、支气管及伴行血管CT定量参数与肺功能、临床指标的相关性。方法将78例COPD患者根据新版的COPD全球倡议分级方法分为轻度组、中度组、重度组、极重度组。从呼气相和吸气相双相上对各组患者右肺上叶尖段支气管进行CT扫描和定量分析,并与肺功能、临床指数进行相关性研究。结果COPD患者随着疾病分级程度的加深,年龄和吸烟指数增高,慢性阻塞性肺病临床测试量表(CAT)评分也逐渐增高(F分别=254.92、839.74、424.08,P均<0.05)。随着疾病分级程度的加深,肺活量(FVC)、第一秒用力呼气容积(FEV1)、及第一秒用力呼气容积与肺活量的比值(FEV1/FVC)逐渐下降,共振频率(Fres)水平逐渐升高(F分别=3122.94、4916.80、1942.82、1584.86,P均<0.05)。随着疾病分级程度的加深,第6级气管气道壁厚度(WT)、管腔周长为10 mm支气管的管壁截面积平方根(Pi10)、管壁面积百分比值(WA%)、低衰减区面积百分比(LAA%)逐渐升高,管腔面积百分比值(Ai%)逐渐下降(F分别=730.81、1336.79、220.91、219.34、124.32,P均<0.05),其中极重度组LAA%明显高于轻度组、中度组及重度组,差异均有统计学意义(t分别=83.14、60.26、43.17,P均<0.05)。相关性分析显示,WT、Pi10、WA%、Ai%及LAA%与FEV1、FVC及FEV1/FVC呈明显负相关(r分别=-0.41、-0.41、-0.38;-0.42、-0.40、-0.41;-0.60、-0.51、-0.60;-0.61、-0.50、-0.60;-0.86、-0.74、-0.87;P均<0.05)。WT、Pi10、WA%、Ai%及LAA%与年龄、吸烟指数及CAT评分呈明显正相关(r分别=0.42、0.47、0.43;0.23、0.42、0.42;0.34、0.36、0.57;0.84、0.89、0.56,P均<0.05)。结论定量CT测量参数与肺功能有相关性,其中LAA%与肺功能相关性更高,对COPD患者肺气肿评估的价值相对更大。
ObjectiveTo study the correlation of CT quantitative parameters of emphysema,bronchus,and accompanying vessels and pulmonary function in patients with chronic obstructive pulmonary disease(COPD).MethodsAccording to the new GOLD grading method,78 patients with COPD were divided into mild group,moderate group,severe group,and extremely severe group.CT scan and quantitative analysis of the right upper lobar apical bronchus in each group were performed from the expiratory phase and inspiratory phase,and the correlation with pulmonary function and clinical index was studied.ResultsThe age and smoking index gradually increased with the deepening of disease lesions as well as the COPD assessment test(CAT)score(F=254.92,839.74,424.08,P<0.05).While the forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),the ratio of forced expiratory volume to vital capacity in the first second(FEV1/FVC)gradually decreased and resonance frequency(Fres)gradually increased with the deepening of the disease lesions(F=3122.94,4916.80,1942.82,1584.86,P<0.05).With the deepening of the disease lesions,the 6 th grade tracheal airway wall thickness(WT),square root of wall sectional area of bronchus with 10 mm circumference of lumen(Pi10),the percentage of tube wall area(WA%),and the percentage of low attenuation area(LAA%)increased gradually,while the percentage of tube cavity area(Ai%)decreased gradually(F=730.81,1336.79,220.91,219.34,124.32,P<0.05).LAA% in the extremely severe group was significantly higher than that in the mild,moderate and severe groups(t=83.14,60.26,43.17,P<0.05).Correlation analysis showed that WT,Pi10,WA%,Ai%,and LAA% were significantly negatively correlated with FEV1,FVC,and FEV1/FVC(r=-0.41,-0.41,-0.38;-0.42,-0.40,-0.61,-0.50,-0.60;-0.86,-0.74,-0.87,P<0.05).The WT,Pi10,WA%,Ai%,and LAA% were positively correlated with age,smoking index,and CAT score(r=0.42,0.47,0.43;0.23,0.42,0.42;0.34,0.36,0.57;0.84,0.89,0.56,P<0.05).Conclusion CT quantitative parameters are related with lung function in patients with chronic obstructive pulmonary disease,among which LAA% has a higher correlation with lung function and had a greater value in emphysema evaluation in COPD patients.
作者
余鸿艳
YU Hongyan(Department of Respiratory Medicine,The First People’s Hospital of Chun’an County,Chun’an 311700,China)
出处
《全科医学临床与教育》
2020年第3期219-222,共4页
Clinical Education of General Practice
关键词
慢性阻塞性肺疾病
定量CT
肺功能
临床
相关性
chronic obstructive pulmonary disease
quantitative CT
lung function
clinical
correlation
