胸部定量CT对COPD患者治疗反应预测因素分析  

Predictive factors for the treatment response of patients with chronic obstructive pulmonary disease by quantitative chest CT scan

作　　者：刘佳萍[1] 张卫国[2] LIU Jiaping;ZHANG Weiguo(Department of Medical Imaging,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;不详)

机构地区：[1]首都医科大学附属北京胸科医院医学影像科,北京市101149 [2]首都医科大学附属北京朝阳医院医学影像科

出　　处：《河北医药》2024年第3期376-379,共4页Hebei Medical Journal

基　　金：北京市科技计划课题(编号:z151100002115049)。

摘　　要：目的分析胸部定量CT扫描对慢性阻塞性疾病(COPD)患者治疗反应的预测因素。方法回顾性分析2018年8月至2021年2月接受治疗COPD患者120例的临床资料,对其随访1年,根据肺功能检测结果将其分为有治疗反应组[n=24,第1秒用力呼气容积(FEV_(1))增加≥0.225 L]和非无治疗反应组(n=96,FEV_(1)增加<0.225 L)。对2组一般资料进行单因素分析,对其中差异有统计学意义的变量进行多因素Logistic回归分析,从而筛选出预测COPD患者治疗反应的因素。结果单因素分析结果显示,有治疗反应组和无治疗反应组在EI、ATI、Pi10、WA%、T方面的差异有统计学意义(P<0.05),而2组间性别比、年龄、体重指数、GOLD分期、入院肺功能检测的差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,Pi10为预测COPD患者治疗反应的因素(OR=2.321,P<0.05)。ROC曲线显示,Pi10在预测COPD患者治疗反应中具有极高的临床价值,ROC曲线显示,Pi10预测COPD患者治疗反应的曲线下面积为0.701,95%CI为0.610~0.781,约登指数为0.354,最佳截断值为4.65 mm,灵敏度为85.40%,特异度为50.00%。结论胸部定量CT扫描参数Pi10能够帮助预测COPD患者治疗反应。Objective To analyze predictive factors for the treatment response in patients with chronic obstructive pulmonary disease(COPD)by quantitative chest computed tomography(CT)scan.Methods The clinical data of 120 COPD patients who were treated in our hospital from August 2018 to February 2021 were retrospectively analyzed.They were followed up for 1 year,and divided into treatment response group(n=24,FEV1≥0.225L)and non-response group(n=96,FEV1<0.225L)with the cut-off value of the increase in the forced expiratory volume in one second(FEV1)of 0.225L.Clinical data were subjected to the univariate logistic regression analysis,and those with significantly differences were introduced to the multivariate logistic regression analysis to identify predictive factors for the treatment response of COPD.Results Univariate logistic regression analysis showed significant differences in the emphysema index(EI),air-trapping indices(ATI),airway wall thickness normalized to an airway lumen of 10-mm inner perimeter(Pi10),percentage wall area(WA%),and airway wall thickness(T)between the treatment response group and the non-response group(P<0.05).There were no significant differences in the sex,age,body mass index(BMI),the Global Initiative for Chronic Obstructive Lung Disease(GOLD)stage,and pulmonary function on admission between groups(P>0.05).The results of multivariate logistic regression analysis showed that Pi10 was a predictive factor for the treatment response of COPD patients(OR=2.321,P<0.05).The receiver operating characteristic(ROC)curve showed that Pi10 had an extremely high clinical value in predicting the treatment response of COPD patients,with the area under the curve of 0.701(95%CI:0.610-0.781,Youden index=0.354,cut-off value=4.65mm,sensitivity=85.40%,specificity=50.00%).Conclusion The quantitative chest CT scan parameter Pi10 can help predict the treatment response of COPD patients.

关 键 词：慢性阻塞性肺疾病 胸部定量CT 治疗反应 预测因素 

分 类 号：R563[医药卫生—呼吸系统]