慢性阻塞性肺疾病患者胸部多层螺旋CT定量参数及肺功能检测  

Quantitative parameters and pulmonary function test results of multi-slice spiral computed tomography in chronic obstructive pulmonary disease patients

作　　者：刘烨 任静 张璐 LIU Ye;REN Jing;ZHANG Lu(Department of Radiology,General Hospital of the Western Theater Command of the Chinese People's Liberation Army,Chengdu 610083,China)

机构地区：[1]中国人民解放军西部战区总医院放射诊断科,四川成都610083

出　　处：《分子影像学杂志》2022年第4期506-510,共5页Journal of Molecular Imaging

基　　金：四川省科技厅重点研发项目(2018fz0065)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)患者胸部多层螺旋CT定量参数及肺功能检测结果。方法选取2018年8月~2021年9月我院收治的112例COPD患者,根据临床表型将支气管炎型COPD患者纳入支气管组(n=73),将肺气肿型COPD患者纳入肺气肿组(n=39),两组均行两次多层螺旋CT和肺功能检查,间隔4月,比较两组的肺容积指标[深吸气末肺容积(Vin)、深呼气末肺容积(Vex)、Vex/Vin],肺密度指标[深吸气末平均肺密度(MLDin)、深呼气末平均肺密度(MLDex)、MLDex-MLDin],肺功能指标[1s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC],采用Spearman法分析肺容积、肺密度指标与病情严重程度的相关性。结果两组患者末次的FEV1、FEV1/FVC低于首次,FVC高于首次,其中支气管炎组的变化幅度更明显(P<0.05);两组患者末次的Vin、Vex、Vex/Vin和MLDin、MLDex、MLDex-MLDin均低于首次,其中肺气肿组的下降幅度更明显(P<0.05);支气管炎型患者的两次肺功能测量差值FEV1/FVC(%)与肺密度指标MLDex-MLDin呈正相关关系,肺气肿型患者的两次肺功能测量差值FEV1和FEV1/FVC与Vex/Vin、MLDex-MLDin均呈正相关关系(P<0.05)。结论多层螺旋CT联合肺功能检测能显示不同表型COPD患者肺气肿以及支气管的变化,具有一定的临床价值。Objective To explore quantitative parameters and pulmonary function test results of multislice spiral CT in chronic obstructive pulmonary disease(COPD)patients.Methods A totao of 112 COPD patients who were admitted to the hospital were enrolled between August 2018 to September 2021.According to different clinical phenotype of COPD,the patients with bronchitis COPD were divided into bronchitis group(n=73)and the patients with emphysema COPD were divided into emphysema group(n=39).All patients underwent two-time chest multislice spiral CT examinations and pulmonary function tests,with an interval of 4 months.The pulmonary volume indexes[Vex/Vin],pulmonary density indexes[Mean lung density at the end of deep inspiration(MLDin),mean lung density at the end of deep exhalation(MLDex),MLDex-MLDin]and pulmonary function indexes[FEV1,FVC,FEV1/FVC]were compared between the two groups.The correlation between pulmonary volume indexes,pulmonary density indexes and disease severity was analyzed by spearman method.Results At the last time,FEV1 and FEV1/FVC of the two groups of patients were lower than the first time,and the FVC was higher than the first time(P<0.05).Vin,Vex,Vex/Vin and MLDin,MLDex,MLDex-MLDin of the two groups of patients were lower than the first time(P<0.05).The measured difference FEV1/FVC(%)was positively correlated with the lung density index MLDex-MLDin,and the difference FEV1 and FEV1/FVC of the two pulmonary function measurements in patients with emphysema were positively correlated with Vex/Vin and MLDex-MLDin(P<0.05).Conclusion Multislice spiral CT combined with pulmonary function test can show the changes of emphysema and bronchus in COPD patients with different phenotypes,which has certain clinical value.

关 键 词：多层螺旋CT 慢性阻塞性肺疾病 肺密度 肺容积 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统] R816.41[医药卫生—内科学]