CT定量检测在慢性阻塞性肺疾病中的诊断意义  

Diagnostic significance of CT quantitative detection in chronic obstructive pulmonary disease

作　　者：刘艳[1] 郑国利[1] 卜春红[2] 魏俊强[3] 朱孝芹[4] LIU Yan;ZHENG Guoli;BU Chunhong;WEI Junqiang;ZHU Xiaoqin(Department of Radiology,the Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China;Department of Critical Care,the Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China;Department of Orthopeadic Surgery,the Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China;Department of Pharma-cy,the Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院放射科,河北承德067000 [2]承德医学院附属医院重症医学科,河北承德067000 [3]承德医学院附属医院骨外科,河北承德067000 [4]承德医学院附属医院药剂科,河北承德067000

出　　处：《新疆医科大学学报》2021年第8期927-931,共5页Journal of Xinjiang Medical University

基　　金：河北省重点研发计划自筹项目(182777131)。

摘　　要：目的探讨CT定量检测在慢性阻塞性肺疾病(COPD)中的诊断价值。方法选取2018年1月-2020年12月期间于本院门诊就诊的疑似COPD患者157例为研究对象,均进行CT定量检查、肺功能等相关检查,以肺功能检测结果作为金标准,检出COPD,并分析CT定量检测在COPD诊断中的应用。结果157例疑似COPD患者,最终检出COPD112例(71.34%)支气管哮喘20例(12.74%);COPD组第1秒用力呼气量(FEV_(1)),用力肺活量(FVC)及FEV_(1)/FVC值、呼吸相平均肺密度(MLD)、管腔面积(LA)低于非COPD组,呼吸双相体素指数<-950HU肺容积占总肺容积的百分比[VI-950(%)]及管壁面积百分比(WA%)高于非COPD组,差异有统计学意义(P<0.05);经双变量Spearson相关性检验结果显示,肺功能指标FEV_(1)/FVC与VI-950、WA%呈负相关(r<0,P<0.05),与MLD、LA呈正相关(r>0,P<0.05);绘制ROC曲线结果显示,CT定量检测VI-950、MLD、LA、WA%预测COPD的AUC均>0.7,具有较高预测价值,当获得最佳阈值时,可获得最佳预测价值。结论CT定量检测应用于COPD鉴别诊断中具有较高诊断效能,可为临床早期检查提供客观参考依据。Objective To analyze the diagnostic value of CT quantitative detection in chronic obstructive pulmonary disease(COPD).Methods A total of 157 cases of suspected COPD patients in the hospital from January 2018 to December 2020 were selected as the research objects.All patients underwent CT quantitative examination,lung function and other related examinations.The lung function test of COPD was detected as the gold standard,and the application of CT quantitative examination in the diagnosis of COPD was analyzed.Results Among the 157 suspected COPD patients,12(71.34%)had COPD and 20(12.74%)had bronchial asthma;FEV_(1),FVC,FEV_(1)/FVC,MLD and La in the COPD group were lower than those in the non COPD group,and the respiratory biphasic voxel index was lower than950 HU,the percentage of lung volume in total lung volume[VI-950(%)]and the wall area of the tube The pulmonary function index FEV_(1)/FVC was significantly higher than that of the non COPD group(P<0.05).VI-950 and WA%were negatively correlated(r<0,P<0.05),MLD and LA were positively correlated(r>0,P<0.05);ROC curve showed that AUC of VI-950,MLD,LA and WA%in predicting COPD by CT quantitative detection was>0.7,which had high predictive value.When the best threshold was obtained,the best predictive value could be obtained.Conclusion The application of CT quantitative detection in the differential diagnosis of COPD has high diagnostic efficiency,which can provide objective reference for early clinical examination.

关 键 词：慢性阻塞性肺疾病 CT定量检测 诊断效能 

分 类 号：R563.1[医药卫生—呼吸系统]