儿童哮喘肺HRCT空气潴留与肺功能的相关性研究  

Correlative Study of Air Trapping on Lung HRCT with Pulmonary Function Tests in Asthmatic Children

作　　者：张岩[1] 张伟[2] 尚云晓[3] 张楠楠[4] 

机构地区：[1]沈阳辽宁省人民医院放射科,辽宁110016 [2]中国医科大学附属盛京医院放射科,辽宁沈阳110004 [3]中国医科大学附属盛京医院小儿呼吸内科,辽宁沈阳110004 [4]中国医科大学附属盛京医院神经功能检查室,辽宁沈阳110004

出　　处：《中国医学影像学杂志》2010年第3期242-247,共6页Chinese Journal of Medical Imaging

摘　　要：目的:观察儿童哮喘患者呼气末HRCT空气潴留的表现;明确空气潴留的面积与肺功能阻塞性指标如FEV1、FEF25%～75%等的相关性。方法:选择21名哮喘儿童行呼气末HRCT扫描,并于同一天或第2天做肺功能检查。在HRCT上分别于上、中、下肺野选取2个可清晰显示空气潴留的层面。用一张规格为2mm×2mm的透明方格纸对空气潴留的面积进行评估。根据空气潴留面积占全肺面积的比例,将其分为3级:Ⅰ级<5%,Ⅱ级5%～25%,Ⅲ级>25%。然后将空气潴留的级别与肺功能的指标做相关性分析。结果:①哮喘儿童肺呼气末HRCT空气潴留出现率为90.5%(19/21);②下叶是空气潴留最好发的部位,占100%(19/19);③空气潴留级别与肺功能阻塞性指标FEV1、FEF25%～75%、FEF50%显著相关,相关系数分别为(r=-0.565,P<0.01;r=-0.499,P<0.05;r=-0.521,P<0.05)。④肺功能正常的哮喘儿童肺HRCT空气潴留出现率为87.5%(14/16)。肺功能正常的哮喘儿童在肺HRCT可观察到明显的空气潴留征,其空气潴留级别可达到Ⅱ、Ⅲ级。结论:肺呼气末HRCT空气潴留可直观显示气道病变的不均匀分布及病变的严重程度;空气潴留征比肺功能异常改变出现早,其敏感性明显高于肺功能检查,可用于评价肺功能正常的哮喘儿童的小气道病变。Objiective To detect imaging findings of air trapping on end expiratory HRCT in asthmatic children,and To analyse the correlation between area of air trapping and measurement of pulmonary function tests（PFT） that reflect airway obstruction,e.g.FEV1、FEF25%-75%,etc.Materials and Methods Lung HRCT scans were obtained at end expiration in 21 asthmatic children,and PFT were performed on the same day or the next day.Two visible sections of air trapping were respectively chosen at the upper,middle and lower lung fields.The areas of air trapping were calculated manually by using a lucent grid.according to the percentage of the air trapping area and the whole lung fields,the degree of air trapping was classified into three grades：grade I,5%;grade II,5%~25%;III,25%.correlation between the grade of air trapping and measurement of pulmonary function tests was analysed.Results ①The frequency of air trapping on end expiratory lung HRCT in asthmatic children was 90.5%（19/21）;②The lower lobe was the most commonly occurred part of air trapping,which was 100%（19/19）;③The grade of air trapping had significant correlation with PFT：FEV1、FEF25%-75%、FEF50%（r=-0.565,P0.01;r=-0.499,P0.05;r=-0.521,P0.05,respectively）;④The frequency of air trapping was 87.5%（14/16） in asthmatic children whose PFT was normal.Obvious air-trapping was observed on Lung HRCT in asthmatic children whose PET is normal,the grade of air trapping could be II or III grade.Conclusion Air trapping on end expiratory lung HRCT scan can directly reflect heterogeneous distribution and degree of airway diseases.Air trapping appears earlier than abnormality of PFT and is more sensitive than PFT,which can be used to assess small airway function of asthmatic children whose PFT is normal.

关 键 词：体层摄影术 X线计算机 哮喘 空气潴留 呼吸功能试验 儿童 

分 类 号：R725.622.504.5[医药卫生—儿科]