慢性阻塞性肺疾病患者下呼吸道内气流特性  

Characteristics of airflow in the lower airways of patients with COPD

作　　者：成志国 黄城督 陈晓琴 钟彦 明照凯 陈广新[1] 孙延斌 CHENG Zhiguo;HUANG Chengdu;CHEN Xiaoqin;ZHONG Yan;MING Zhaokai;CHEN Guangxin;SUN Yanbin(School of Medical Imaging,Mudanjiang Medical University,Heilongjiang,Mudanjiang 157011,China;School of Public Health,Mudanjiang Medical University,Heilongjiang,Mudanjiang 157011,China)

机构地区：[1]牡丹江医学院医学影像学院,黑龙江牡丹江157011 [2]牡丹江医学院公共卫生学院,黑龙江牡丹江157011

出　　处：《中国医药科学》2023年第15期16-19,共4页China Medicine And Pharmacy

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(2020-KYYWFMY-0052)。

摘　　要：目的运用计算流体力学方法探究慢性阻塞性肺疾病(COPD)患者下呼吸道内气流特性。方法选取3例2021年5月于牡丹江医学院附属红旗医院收治的COPD患者与1例同月健康体检者(正常对照者),对其胸部CT扫描数据重建真实下呼吸道三维模型,通过施加符合人体生理的边界条件进行数值模拟,并将COPD患者下呼吸道壁面压力、壁面剪切应力(WSS)、压降及流速等参数与正常下呼吸道进行比较分析。结果COPD患者下呼吸道各力学指标与正常对照者表现出显著差异。COPD患者呼吸道整体壁面压力高于正常对照者;3级以上支气管WSS明显较高,COPD患者WSS>0.2 Pa所占面积分别为654、1375及617 mm^(2),而正常对照者为171 mm^(2);COPD患者具有更大的压降值7.30、9.67及7.51 Pa,而正常对照者为3.99 Pa;患者整体流速明显高于正常人,且出现较多涡流。结论计算流体力学方法是评估COPD患者支气管功能改变的有价值的手段,为患者发生呼吸道炎症以及缺氧等症状提供力学角度解释。Objective To investigate the characteristics of airflow in the lower airways of patients with chronic obstructive pulmonary disease(COPD)using the computational fluid dynamics method.Methods Three patients with COPD admitted to Hongqi Hospital Affiliated to Mudanjiang Medical University in May 2021 and another patient(normal control subjects)who passed the health examination in the same month were selected to reconstruct a three-dimensional model of the real lower airway based on their chest CT scan data.Numerical simulations were performed by imposing boundary conditions consistent with human physiology.The parameters including wall pressure,wall shear stress(WSS),pressure drop and flow rate of lower airways in the three patients with COPD were compared with the patient in the normal control.Results The mechanical indices of the lower airways of the three patients with COPD showed significant differences from the patient of the normal control.The overall airway wall pressure of the three patients with COPD was higher than that of the normal control subjects.The WSS in the bronchi of Grade 3 or higher was significantly higher,with 654 mm^(2),1375 mm^(2) and 617 mm^(2) occupied by WSS>0.2 Pa in the three patients with COPD than171 mm^(2) in the normal control subjects.The three patients with COPD had higher pressure drops(7.30 Pa,9.67 Pa,and 7.51 Pa,respectively)compared to the normal control subjects(3.99 Pa).Significantly higher overall flow rate with more vortices were found in the three patients with COPD,compared with the normal control.Conclusion Computational fluid dynamics method is a valuable tool for assessing altered bronchial function in patients with COPD and provides a mechanical explanation for the occurrence of symptoms such as respiratory inflammation and hypoxia in patients.

关 键 词：下呼吸道建模 慢性阻塞性肺疾病 计算流体力学 数值模拟 

分 类 号：R563.9[医药卫生—呼吸系统]