320排螺旋CT低剂量呼吸双相扫描对COPD急性加重期患者肺功能的评估价值  

Evaluation of pulmonary function in patients with acute exacerbation of COPD using 320 row spiral CT low dose biphasic respiratory scanning

作　　者：纪蒙蒙[1] 李永[1] 朱晓龙[1] 邹殿俊[1] 耿鹤群[1] 杨飞[1] 崔书君[1] 朱月香[1] JI Meng-meng;LI Yong;ZHU Xiao-long;ZOU Dian-jun;GENG He-qun;YANG Fei;CUI Shu-jun;ZHU Yue-xiang(Department of Medical Imaging,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院医学影像部,河北张家口075000

出　　处：《川北医学院学报》2023年第12期1616-1619,1628,共5页Journal of North Sichuan Medical College

基　　金：河北省医学科学研究重点课题(20180873)。

摘　　要：目的:探讨320排螺旋CT低剂量呼吸双相扫描对慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能的评估价值。方法:选取AECOPD患者及COPD缓解期患者各53例,均进行320排螺旋CT低剂量呼吸双相扫描,通过软件沿叶间胸膜进行全肺分割,并计算全肺、左肺和右肺、左右肺各肺叶最大深吸气末各肺叶肺容积(Vin)、深呼气末各肺叶肺容积(Vex)、呼吸两相容积差Vin-Vex以及容积比Vin/Vex。所有患者均进行肺功能指标[第1秒用力呼气容积(FEV1)和用力肺活量(FVC)]检测并根据客观情况填写COPD评估测试问卷(CAT)。比较AECOPD组与COPD缓解期组患者各指标水平,并分析AECOPD组患者呼吸双相肺容积差、容积比与肺功能评估相关指标(FEV1、FEV1/FVC%、CAT)的相关性。结果:两组全肺、左肺、左下肺、右肺、右下肺的Vin、Vex比较差异有统计学意义(P<0.05),左上肺、右上肺、右中肺的Vin、Vex比较差异均无统计学意义(P>0.05);两组左下肺、右下肺的Vin-Vex比较,差异有统计学意义(P<0.05),全肺、左肺、左上肺、右肺、右上肺、右中肺的Vin-Vex比较,差异无统计学意义(P>0.05);两组全肺、左肺、右肺及各肺叶的Vin/Vex比较,差异均无统计学意义(P>0.05)。AECOPD组FEV1%pred、FEV1/FVC水平均低于COPD缓解期组,CAT评分高于COPD缓解期组(P<0.05)。左下肺及右下肺Vin-Vex与FEV1%pred、FEV1/FVC均呈负相关关系(P<0.05),与CAT评分正相关(P<0.05)。结论:320排螺旋CT低剂量呼吸双相扫描可有效评估AECOPD患者肺功能。Objective:To investigate the value of 320 slice spiral CT low dose biphasic respiratory scanning in the evaluation of pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 53 patients with AECOPD and 53 patients with COPD in remission were selected to undergo low-dose respiratory biphasic scan with 320-slice spiral CT,and whole-lung segmentation was performed along the interlobular pleura by software.The maximum lobar volume(Vin)at the end of deep inspiration,the maximum lobar volume(Vex)at the end of deep expiratory breath,Vin-VEX and the volume ratio Vin/Vex were calculated for the whole lung,left and right lung,left and right lung.All patients were tested for pulmonary function indicators[forced expiratory volume(FEV1)and forced vital capacity(FVC)in the first second]and filled in a COPD evaluation questionnaire(CAT)based on objective conditions.The levels of various indicators were compared between the AECOPD group and the COPD remission group,and the correlation between the respiratory biphasic lung volume difference,volume ratio,and lung function evaluation related indicators(FEV1,FEV1/FVC%,CAT)were analyzed in the AECOPD group.Results:There were statistically significant differences in Vin and Vex of whole lung,left lung,left lower lung,right lung and right lower lung between the two groups(P<0.05),while there were no statistically significant differences in Vin and Vex of left upper lung,right upper lung and right middle lung between the two groups(P>0.05).There were statistically significant differences in Vin-Vex between the two groups in the left lower lung and the right lower lung(P<0.05),but there were no statistically significant differences in Vin-Vex between the whole lung,left lung,left upper lung,right lung,right upper lung and right middle lung(P>0.05).There was no significant difference in Vin/Vex of whole lung,left lung,right lung and each lung lobe between the two groups(P>0.05).The levels of FEV1%pred and FEV1/FVC in AECOP

关 键 词：慢性阻塞性肺疾病 急性加重期 320排螺旋CT 低剂量 呼吸双相扫描 肺容积 

分 类 号：R563.9[医药卫生—呼吸系统]