CT肺气肿表型及其定量指标与慢性阻塞性肺疾病患者肺功能和预后的相关性分析  

Correlation analysis of T emphysema phenotype and its quantitative indicators with lung function and prognosis in patients with chronic obstructive pulmonary disease

作　　者：罗杨 杨文柱 杨跃跃 LUO Yang;YANG Wenzhu;YANG Yueyue(Department of Imaging,Affiliated Hospital of West Anhui Health Vocational College,Lu′an,Anhui 237008,China;Department of Respiratory Medicine,Affiliated Hospital of West Anhui Health Vocational College,Lu′an,Anhui 237008,China)

机构地区：[1]皖西卫生职业学院附属医院影像科,安徽六安237008 [2]皖西卫生职业学院附属医院呼吸内科,安徽六安237008

出　　处：《临床肺科杂志》2025年第5期698-705,共8页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨慢性阻塞性肺疾病(简称慢阻肺)患者的CT肺气肿表型及其定量指标与肺功能和患者预后的相关性。方法纳入2020年1月-2023年6月收治的180例慢阻肺患者,根据其CT检查所示的肺气肿表现与支气管壁变化特征,分为A型组(n=67)、E型组(n=60)和M型组(n=53)。分析所有患者的CT定量指标与肺功能指标及其相关性;记录患者随访1年期间的急性加重情况,并分析其独立影响因素。结果肺功能指标方面,A型组患者的FEV_(1)/FVC和FEV_(1)%pred水平两项指标均显著高于E型组和M型组,E型组的FEV_(1)/FVC和FEV_(1)%pred水平显著高于M型组,差异均有统计学意义(P<0.05);A型组患者的RV/TLC比率显著低于E型组和M型组,差异均有统计学意义(P<0.05)。定量指标方面,A型组的Vin水平显著高于E型组和M型组,E型组的Vin水平显著高于M型组,上述差异均有统计学意义(P<0.05);A型组的Vex水平显著低于E型组和M型组(P<0.05),E型组的Vex水平显著低于M型组,上述差异均有统计学意义(P<0.05);A型组的EIex水平显著低于E型组和M型组(P<0.05),E型组的EIex水平显著低于M型组,上述差异均有统计学意义(P<0.05)。Pearson相关性分析显示,Vin与FEV_(1)/FVC和FEV_(1)%pred呈正相关,与RV/TLC呈负相关;Vex和EIex均与FEV_(1)/FVC和FEV_(1)%pred呈负相关,与RV/TLC呈正相关。A型组1年内慢阻肺急性加重的发生率为5.97%,显著低于E型组的18.33%和M型组的22.64%(P=0.027)。多因素Logistic回归分析显示,FEV_(1)/FVC和CT肺气肿表型均是慢阻肺患者随访1年急性加重的独立影响因素(P<0.05)。结论CT肺气肿表型及其定量参数与慢阻肺患者的肺功能存在明确的相关性;此外,FEV_(1)/FVC比值以及CT肺气肿表型均是慢阻肺患者出院后1年内急性加重的独立影响因素。Objective To explore the correlation between CT emphysema phenotypes,their quantitative indices,lung function,and patient prognosis in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 180 COPD patients admitted from January 2020 to June 2023 were enrolled and classified into Group A(n=67),Group E(n=60),and Group M(n=53)based on their CT scan features of emphysema and bronchial wall changes.CT quantitative indices and lung function parameters were analyzed for all patients,and their correlations were examined.Acute exacerbations during one-year follow-up were recorded,and independent influencing factors were analyzed.Results In terms of pulmonary function indicators,the FEV_(1)/FVC and FEV_(1)%predicted levels in Group A were significantly higher than those in Groups E and M.The FEV_(1)/FVC and FEV_(1)%predicted levels in Group E were significantly higher than those in Group M,with all differences being statistically significant(P<0.05).The RV/TLC ratio in Group A was significantly lower than that in Groups E and M,with the differences also being statistically significant(P<0.05).Regarding quantitative indicators,the Vin level in Group A was significantly higher than that in Groups E and M,while the Vin level in Group E was significantly higher than that in Group M,with all differences being statistically significant(P<0.05).The Vex level in Group A was significantly lowerthan that in Groups E and M(P<0.05),and the Vex level in Group E was significantly lower than that in Group M,with all differences being statistically significant(P<0.05).The EIex level in Group A was significantly lower than that in Groups E and M(P<0.05),and the EIex level in Group E was significantly lower than that in Group M,with all differences being statistically significant(P<0.05).Pearson correlation analysis showed that Vin was positively correlated with FEV_(1)/FVC and FEV_(1)%pred and negatively correlated with RV/TLC.Both Vex and EIex were negatively correlated with FEV_(1)/FVC and FEV_(1)%pred and positiv

关 键 词：慢性阻塞性肺疾病 CT肺气肿表型 肺功能 急性加重 

分 类 号：R563.9[医药卫生—呼吸系统]