肺高分辨率CT测定支气管壁增厚与慢性阻塞性肺疾病病情严重程度及其疗效的关系  

Relationship between bronchial wall thickness of HRCT examination and the severity and prognosis of chronic obstructive pulmonary disease

作　　者：鲁雪红[1] 康淑琴[1] 栾丽[1] Lu Xuehong;Kang Shuqin;Luan Li(Imaging Center,Affiliated Chinese Medicine Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院影像中心,乌鲁木齐830000

出　　处：《中国医学装备》2024年第9期38-41,共4页China Medical Equipment

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D01C812)。

摘　　要：目的:探讨肺高分辨率CT(HRCT)支气管壁增厚与慢性阻塞性肺疾病(COPD)肺功能及其疗效的相关性。方法:回顾性选择2020年1月至2022年12月新疆医科大学附属中医医院收治的慢性阻塞性肺疾病患者154例作为观察组;根据第1秒用力呼气容积的百分比(FEV1%)指标,按照2023版COPD全球倡议(GOLD)分级,其中Ⅰ级51例、Ⅱ级45例、Ⅲ级35例及Ⅳ级23例;另选择同期健康体检者67名作为健康对照组。行胸部HRCT扫描,测定双侧肺尖支气管开口部位支气管壁厚度;采用肺功能测定仪测定第1秒用力呼气容量的百分比(FEV1%)、第1秒用力呼气容积(FEV1)与用力肺活量百分比的比值(FEV1/FVC%);采用Pearson相关性分析软件对支气管壁增厚与肺功能和疗效完成相关性分析。结果:观察组左肺支气管壁厚度(1.49±0.21)mm及右肺支气管壁厚度(1.52±0.24)mm均大于健康对照组,差异有统计学意义(t=18.041、15.504,P<0.05);观察组中不同GOLD分级下患者分级越高,左肺支气管壁厚度及右肺支气管壁厚度越厚,不同分级各亚组之间左、右双肺支气管壁厚度差异亦均有统计学意义(F=13.888、25.841,P<0.05);观察组不同GOLD分级患者慢阻肺患者FEV1(1.82±0.32)、FEV1/FVC%(63.09±5.26)及FEV1%(63.36±6.03)水平低于健康对照组,差异有统计学意义(t=6.693、15.392、7.944,P<0.05);观察组中GOLD分级下患者级别越高,FEV1、FEV1/FVC%及FEV1%水平下降越低,观察组不同GOLD分级患者肺功能水平比较差异有统计学意义(F=166.541、141.751、57.120,P<0.05);Pearson相关性分析结果表明:COPD患者肺HRCT左肺及右肺支气管壁增厚与肺功能FEV1、FEV1/FVC%及FEV1%水平呈正相关性(r=0.451、0.503、0.498、0.531、0.488、0.515,P<0.05)。结论:肺HRCT支气管壁厚度在COPD患者中呈高表达,其表达水平能反映患者病情严重程度,且与肺功能存在强相关性。Objective:To investigate the correlation between bronchial wall thickness that was determined by high-resolution computed tomography(HRCT)on lung,and pulmonary function and curative efficacy of patients with chronic obstructive pulmonary disease(COPD).Methods:From January 2020 to December 2022,a total of 154 COPD patients were retrospectively selected as the observation group.According to the indicator of the percentage of forced expiratory volume in the first second(FEV1%),the patients were divided into high-risk group(gradeⅠ,n=51),mild group(gradeⅡ,n=45),moderate group(gradeⅢ,n=35)and severe group(gradeⅣ,n=23)as the 2023 global initiative for chronic obstructive lung disease(GOLD)scale.At the same time,67 healthy subjects were selected as healthy control group.All of them underwent HRCT scan on their chest,and the thickness of the bronchial wall at the opening of the bronchus of bilateral lung apex was measured.The percentage of forced expiratory volume at the first second(FEV1%),forced expiratory volume at the first second(FEV1)and FEV1/forced vital capacity(FEV1/FVC%)(percentage of forced vital capacity)were measured by the pulmonary function apparatus.Pearson correlation analysis software was used to analyze the correlation between bronchial wall thickening and lung function and curative efficacy.Results:The left bronchial wall thickness(1.49±0.21)mm and the right bronchial wall thickness(1.52±0.24)mm in the observation group were higher than those in the healthy control group(t=18.041,15.504,P<0.05),respectively.In the observation group,the higher GOLD grading of the subgroup has higher thickness at the left and right sides of bronchial walls,and there were also significant differences at the thicknesses of bilateral bronchial walls among different grading groups(F=13.888,25.841,P<0.05),respectively.The FEV1(1.82±0.32),FEV1/FVC%(63.09±5.26)and FEV1%(63.36±6.03)in COPD patients of the each subgroup of observation group were lower than those of healthy control group,and the differences were stati

关 键 词：高分辨率CT(HRCT) 支气管壁增厚 慢性阻塞性肺疾病(COPD) 肺功能 相关性 

分 类 号：R816.4[医药卫生—放射医学]