慢性阻塞性肺疾病肺气虚证肺容积成像定量分析与症状积分分级的研究  

Quantitative analysis of CT images on lung volume,rating and integral on symptoms: a study on chronic obstructive pulmonary disease patients with syndrome of lung-qi deficiency

作　　者：彭楠[1] 路遥[1] 赵晶[1] 康德强[1] 郭红丽[1] 

机构地区：[1]北京中医药大学东方医院放射科,北京100078

出　　处：《北京中医药大学学报》2016年第5期424-428,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：北京中医药大学临床自主创新课题(No.2011jybzzjsy-096)

摘　　要：目的通过定量CT为慢性阻塞性肺疾病(COPD)的证候分类提供客观有效的量化指标,以揭示证的实质和病机,将功能学量化指标与形态学影像诊断相联系,解决以往影像研究对COPD肺实质损害程度的诊断缺少量化指标的问题。方法收集COPD稳定期肺气虚证患者75例及20例正常对照组病例,参照中药(新药)临床研究指导原则的中医证候计分法将入选病例组分轻、中、重度3个等级,同时进行肺部CT扫描,并通过三维后处理技术用多域值范围成像定量分析反映肺功能状况,将CT量化指标与不同症状积分分级及正常对照组间进行统计学分析比较。结果与正常对照组相比,COPD组所有患者各肺叶容积平均值均有所增大,各叶气肿组织所占肺叶百分比平均值均增加。在各个症状积分分级中,随着积分分级的逐渐加重,各肺叶肺容积及气肿组织所占肺叶百分比也随之增加,其中两肺上叶及右肺中叶气肿组织所占比重较大。结论容积CT测量各肺叶容积及气肿组织百分比与中医症状积分分级有一定的关联性,这种量化指标的引入,增加了中医药治疗COPD的客观性及可信度。Objective To combine the functional quantitative indicators with the morphological imaging diagnosis by quantitative CT on chronic obstructive pulmonary disease（ COPD） patients,so as to provide the objective and quantitative indicators for TCM differentiation and for degrees of lung parenchyma injury. Methods A total of 75 COPD patients at stable stage with syndrome of lung-qi deficiency were divided into three groups（ mild,moderate,severe） in accordance with Clinical Guideline of New Drug for Traditional Chinese Medicine,and 20 more healthy people were recruited into healthy group. After lung CT scan,the multi-range imaging quantitative analysis was carried using the post-proceeding three-dimension technology. Then the CT quantitative indicators and the integral and rating of symptoms of patients were compared with the healthy subjects. Results Compared with the healthy group,the mean volume of each lung lobe,and proportion of emphysema volume increased in all three COPD groups. Furthermore,the more serious the symptoms were,the larger volumes of lung lobes and the more proportion of emphysema volume were. The proportion of emphysema volume in upper lobes or in right middle lobe were larger. Conclusion The correlation between the volume of lung lobes and emphysema and the degrees of integral of TCM symptoms were proved. And the introduction of the quantitative indicators could increase the objectivity and reliability of TCM treatment on COPD.

关 键 词：慢性阻塞性肺疾病 肺容积 症状积分 CT技术 

分 类 号：R259.63[医药卫生—中西医结合]