COPD患者胸部HR CT测定肺气肿相关参数、常规肺功能和IOS肺功能检测指标的相关性分析  

Correlations among the parameters measured by spirometry, impulse oscillometry, and thoracic high-resolutioncomputed tomography in patients with chronic obstructive pulmonary disease

作　　者：唐薪竣 陈淑靖 严瑾 曾健[2] 朱才松[3] 金晓燕[2] Tang Xinjun ,Chen Shujing, Yan Jin, Zeng Jian, Zhu Caisong, Jin Xiaoyan.(Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China)

机构地区：[1]复旦大学附属中山医院呼吸科,上海200032 [2]上海交通大学医学院附属同仁医院呼吸科,上海200336 [3]上海交通大学医学院附属同仁医院影像介入科,上海200336

出　　处：《国际呼吸杂志》2018年第21期1629-1634,共6页International Journal of Respiration

基　　金：上海市卫生和计划委员会科研课题（201540370）

摘　　要：目的 研究慢性阻塞性肺疾病 （COPD）患者的胸部高分辨率CT （HRCT）测定的肺气肿相关参数、常规肺功能检测指标和脉冲振荡 （IOS）肺功能检测指标之间的相关性。方法 纳入2013年1月至2014年10月于上海交通大学医学院附属同仁医院呼吸科住院的COPD患者,使用 Myrian系列软件分析其胸部HRCT图像,计算-950亨氏单位 （HU）以下的肺气肿容积 （EV）、肺总容积 （TLV）以及肺气肿指数 （EI）,并将其与患者的常规肺功能及IOS肺功能检测指标三者之间进行Spearman秩相关分析及偏相关分析。结果 Spearman秩相关分析结果表明,第1秒用力呼气容积 （FEV1）/FVC和FEV1%pred与电抗5 （X5）呈正相关,EV和EI均与FEV1/FVC、FEV1%pred与阻抗20 （R20）呈负相关,TLV与阻抗5 （R5）呈负相关。控制年龄和体质量指数的偏相关分析结果表明,FEV1%pred与X5之间呈正相关,EV和EI与FEV1/FVC、FEV1%pred以及R20之间呈负相关,差异有统计学意义,同时TLV与共振频率、R5、R20和R5-R20之间呈负相关。结论 IOS肺功能和 HRCT有助于COPD患者的诊断和病情评估。Objective To determine the correlations among the airflow limitation examined by spirometry, the airway resistance and reactance measured by impulse oscillometry （lOS）, and the parameters quantified by thoracic high-resolution computed tomography （HRCT） in patients with chronic obstructive pulmonary disease （COPD）. Methods Medical records from January 2013 to October 2014 of in-patients with COPD in Tongren Hospital, Shanghai Jiaotong University School of Medicine were retrospectively evaluated. HRCT images were analyzed, in which emphysema volume （EV）, total lung volume （TLV）, and emphysema index （EI） under --950 hounsfield unit （HU） were calculated. The correlations among the airflow limitation, the airway resistance and reactance, and the parameters of HRCT were determined by Spearman correlation analysis and partial correlation analysis. Results The Spearman correlation analysis demonstrated that FEV1/FVC and FEV1 M pred were significantly correlated positively with reactance 5 （X5）;EV and EI were significantly correlated negatively with FEV1/FVC, FEVI % pred, and resistance 20 （ R20 ） ; and TLV was significantly correlated negatively with resistance 5 （R5）. With age and body mass index adjusted, FEV1 M pred wassignificantly correlated positively with X5;EV and EI were significantly correlated negatively with FEVI/FVC, FEV1 pred, and R20;and TLV was significantly correlated negatively with resonance frequency, R5, R20 and R5-R20. Conclusions Besides spirometry, IOS and thoracic HRCT are complementary in the diagnosis and assessment in patients with COPD.

关 键 词：慢性阻塞性肺疾病 高分辨率CT 常规肺功能 脉冲振荡肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]