慢性阻塞性肺气肿上呼吸道病变的CT观察

CT findings of the upper airways in patients with chronic obstructive emphysema

目的 分析慢性阻塞性肺气肿上呼吸道的变化。方法 对 4 0例确诊为慢性阻塞性肺气肿患者和同期 39例正常对照者行肺部螺旋CT扫描。测量以下指标并进行统计学分析 :(1)气管横截面积 (Ta) ;(2 )气管指数 (Ti) ,即气管的最大横径 (Tc)和最大矢径 (Ts)的比率 ;(3)左、右主支气管直径 (分别记为Bl和Br) ;(4 )左、右主支气管的分叉角度 (Ba) ;(5 )胸廓指数 (Thi) ;(6 )气体潴留指数 (Ati)。结果 除Ba外 ,气肿组与对照组上述指标的均值差异都有显著性意义 ,气肿组的Ti与Ati呈明显的负相关 (r =- 0 5 93,P <0 0 0 1) ,Ti与Thi呈明显的正相关 (r =0 5 37,P <0 0 1)。Ta与Ati(r =0 10 5 ,P >0 0 5 )和Ta与Ti(r =- 0 12 5 ,P >0 0 5 )均无明显的相关关系。结论 Ti减小是慢性阻塞性肺气肿气管的主要变化 。

Objective To analyze CT findings of the upper airways in patients with chronic obstructive emphysema (COE). Methods Forty patients with COE proved by clinical and pulmonary function testing, and 39 control patients were examined by chest spiral CT scanning. Parameters were measured and statistically analyzed as follows: (1) the average tracheal cross sectional area (Ta); (2) the tracheal index (Ti), defined by the ratio between the coronal and sagittal diameters as measured 1 cm above the aorta arch; (3) the average right and left main stem bronchi diameters (Br, Bl); (4) the average bifurcate angle of the bronchi (Ba); (5) the thorax index (Thi); (6) the air trapping index (Ati). Results In above-mentioned measurements, significant differences were revealed between COE group and control group except Ba. There were significant negative correlation between Ti and Ati (r=-0.593, P<0.001) and significant positive correlation between Ti and Thi (r=0.537, P<0.01) in COE. There were no significant correlation between Ta and Ati (r=0.105, P>0.05), Ta and Ti (r=-0.125, P>0.05) in COE. Conclusion The trachea change in patients with COE showed decreasing Ti, and Ti correlated significantly with Thi and Ati.