COPD小气道重塑的HRCT研究及与肺功能的相关性  

HRCT Study on Correlation of Small Airway Remodeling in COPD and Lung Function

作　　者：于寰[1,2] 张朝阳[3] 范丽[2] 管宇[2] 夏艺[2] 肖湘生[2] 江海林[2] 

机构地区：[1]首都医科大学良乡教学医院 [2]第二军医大学附属长征医院影像科 [3]中国人民解放军91395部队卫生队

出　　处：《临床放射学杂志》2013年第7期943-946,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金(青年)项目(编号:81000602);上海市自然基金项目(编号:10ZR1438900)

摘　　要：目的采用HRCT定量评价不同级别的慢性阻塞性肺疾病(COPD)患者4～7级支气管径线,并分析其与肺功能参数间的相关性。方法对80例COPD患者分别进行胸部HRCT扫描及肺功能检查。以多平面重组方式重组右肺上叶尖段支气管,测量其4～7级支气管壁横截面的气道壁各参数,并与肺功能结果进行Pearson相关性分析。结果 COPD的气道壁各径线与肺功能结果有统计学差异(P<0.05),管壁面积占支气管断面总面积的百分比(WA%)与用力呼气第1秒量(FEV1)呈负性相关(r=-0.416～-0.614,P<0.001),与用力肺活量(FVC)呈负性相关(r=-0.304～-0.533,P<0.001),与25%最大呼气流量(MEF 25%)呈负性相关(r=-0.269～-0.365,P<0.001)。壁厚度与外直径的比率(TDR)与FEV1呈负性相关(r=-0.048～-0.593,P<0.001),与FVC呈负性相关(r=-0.304～-0.526,P<0.001),与MEF 25%呈负性相关(r=-0.269～-0.361,P<0.001)。结论 HRCT所测量的COPD气道壁径线,尤其WA%和TDR与肺功能有较好的负性相关性。HRCT能显示COPD患者4～7级支气管的解剖细节且所得气道定量参数与肺功能指标具有相关性。Objective To evaluate the different levels of 4 -7 bronchial airway wall dimensions in patients with COPD using HRCT, and analyze its correlation with lung function parameters. Methods 80 patients with COPD received HRCT and pulmonary function tests, multiplanar reconstruction （MPR） was used to reconstruct tip segment of the right lung bron- chus and measure 4 - 7 level of the bronchial wall cross - section of the parameters of the airway wall, and its correlation with lung function parameters was analyzed. Results There were significant difference between COPD and lung function resuhs （P 〈0.05 ） , WA% was negatively correlated with FEV1 （r = -0. 416 ～ -0. 614 ,P 〈0.001 and negatively corre- lated with FVC （ r = - 0. 304 ～ - 0. 533, P 〈 0.001 ）, and also was negatively correlated with MEF25% （ r = - 0. 269 ～-0. 365 ,P 〈0. 001 ）. TDR was negatively correlated with FEV1 （r = -0 048～ -0. 593 ,P 〈0.001 ） and was negatively correlated with FVC （r = -0. 304 ～ -0. 526,P 〈0. 001 ）, and MEF25% （ r = -0. 269 ～ -0. 361 ,P 〈0.001 ）. Con- clusion HRCT can he used to measure airway wall dimensions, especially WA% and TDR have good correlation with lung function. HRCT can show and assess the severity and impairment of lung function.

关 键 词：体层摄影术 X线计算机 肺功能检查 慢性阻塞性肺疾病 气道壁 

分 类 号：R563.9[医药卫生—呼吸系统]