不同分级慢性阻塞性肺疾病患者胸部定量CT变化的研究  

Study of change of chest quantitative CT about different classification chronic obstructive pulmonary disease patients

作　　者：韩文[1] 许建英[1] 武志峰[2] 刘虎[1] 江小鹏[2] 

机构地区：[1]山西医科大学附属大医院呼吸科,太原030032 [2]山西医科大学附属大医院CT室,太原030032

出　　处：《国际呼吸杂志》2013年第9期666-670,共5页International Journal of Respiration

基　　金：山西省卫生厅科技攻关计划项目（2011002）

摘　　要：目的通过分析不同分级慢性阻塞性肺疾病（COPD）稳定期患者胸部定量CT的变化及其与肺功能和症状评分的相关性，探讨其能否做为评估COPD严重程度的方法之一。方法研究对象为山西医科大学附属大医院呼吸科门诊的90例COPD患者，均行肺功能及胸部定量CT检查，症状评估采用MMRC问卷。根据2011年版GOLD综合评估的方法分为A、B、C和D四组。分别对各组肺功能、胸部定量CT肺气肿评估指标LAA％及症状评分进行相关性分析。结果①肺功能：FEV。％pred、VC、DLAdi、FEF75分别在A、B、c和D四组间差异有统计学意义（F分别为59．83，18．56，14．39，16．06，P值均〈O．05）；且c、D组均分别小于A和B组，差异均有统计学意义（P值均〈O．05）；A、B组间及C、D组间差异均无统计学意义（P值均〉O．05）。RV，RV／TLC在A、B、c和D四组间差异无统计学意义（P值均〉O．05）。②胸部定量CT：LAA％在CT阈值分别-1024～-970、-960、-950、-940、-930、-920、-910HU值下均为一致结果。在一l024～-910HU下，A、B、c和D四组间LAA％差异有统计学意义（F：20．22，Pd0．05），两两比较，C和D组LAA％分别大于A和B组，差异均有统计学意义（P值均〈O．05），B组大于A组，差异均有统计学意义（P〈0．05），C组与D组差异无统计学意义（P〉0．05）。③相关性：④LAA％与肺功能各指标：在-1024910HU下LAA％与FEV。％pred、FEF75、DI。Adj均呈显著负相关，（r分别为-0．686，-0．509，-0．481，均Pd0．01）；与RV和RV／TLC无相关性（P=0．34）。⑥LAA％与症状评分：在～1024—910HU下LAA％与MMRC呈显著正相关，（r=0．570，Pd0．01）。⑥症状评分与肺功能各项指标：MMRC与FEV，％pred、FEF75及DLAdj呈显著负相关（r分别为-0．493，-0．330，-0．267，前两者P值均d0．01，后者Pd0．05）。结论肺气肿可能为A、B两组患者临床症状出现差异的�Objective Through the analysis of the patientsrs Chest quantitative CT changes that with different classification of chronic obstructive pulmonary disease （COPD） and pulmonary function and the correlation of symptom scores, and discussed it can be or not as a way of assessment of the severity of COPD. Methods The research object were our respiratory medicine outpatient service of 90 cases of patients with COPD, each patient did pulmonary function and chest quantitative CT examination, the symptom assessment using MMRC questionnaire. According to the 2011 GOLD guide joint assessment method is divided into A, B, C and D groups. Each group respectively on pulmonary function, chest CT pulmonary emphysema quantitative evaluation index LAA % and symptom scores for correlation analysis. Results （1） Pulmonary function： The four FEV1% pred, VC, DL Adj, FEF75 were statistically significant difference respectively in A, B, C and D four groups. （ F = 59.83,18.56,14.39,16.06 ,all P G 0.05）, and C, D group respectively are less than A and B group, the differences were statistically significant （ P G0.05）, A and B, C and D between-group differences were no statistical significance （ P 0.05）. RV, RV/TLC in A, B, C and D four groups difference was not statistically significant （ P 0.05）. （2）Chest quantitative CT.. LAA% In CT threshold respectively -1 024～ - 970,～- 960, ～-950, ～- 940, ～- 930, ～- 920, ～- 910 HU values are consistent results, in -1 024 ～-910 HU, LAA 0% in A, B, C and D four groups rs difference have statistical significance （ F =20. 22, P 〈0.05） ,pairwise comparation,LAA% in C and D group were greater than A and B group, the differences were statistically significant （P 〈0.05）. Group B more than in group A, the differences were statistically significant （ P 〈 0.05）. C and D group difference was not statistically significant （ P 〈0.05）. （3）Correlation;@LAA% and pulmonary function each index LAA% （in -1 024～- 910 HU）, with FEV1% pred, FEF7

关 键 词：慢性阻塞性肺疾病 肺气肿 胸部CT 肺密度衰减区域百分比 改良的英国医学研究委 员会呼吸困难量表评分 

分 类 号：R563.9[医药卫生—呼吸系统]