慢性阻塞性肺疾病的病理基础与HRCT的对比研究

Comparative research on of pathologic basis and HRCT in chronic obstructive pulmonary disease

目的:通过HRCT的表现来揭示慢性阻塞性肺疾病(COPD)的病理进程,为临床及早干预及选择治疗方案提供依据。方法:分析96例临床确诊的COPD病例的HRCT表现与56例无COPD病史的外伤病例作对照,从中央气道病变,外周气道病变,肺实质病变及肺血管病变等四方面来评估COPD的病理学改变。结果:COPD的中央气道T,T/D,Ai,WA%及TI等指标与对照组比较,差异有显著性(P<0.01),外周气道的显示率,肺气肿及“马赛克灌注”的发生率均较对照组高,经统计学检验,差异有显著性(P<0.01)。结论:HRCT可以从影像学角度反映COPD的病理改变,结合肺功能检查,可更准确地揭示COPD的病程发展,从而为临床选择治疗方案提供客观依据。

Objective： We expect to reveal COPD pathologic progress through HRCT performance, which is to provide a basis for the early interference and the choice of therapeutic schedule. Methods： To analyze the performance of 96 clinical definite diagnosis and compare the 96 cases above with 56 external injury cases without COPD disease history , we can find four kinds of changes on HRCT,that is： the central airway pathological changes, the surface airway pathological changes, the lung substance pathological changes and lung bloed-vessel pathological changes, which can be used to evaluate COPD pathologic changes. Results：Tile difference of the central airway indext T.T/D, Ai, WA% and TI between the subjects has been shown by statistics （ P 〈 0.01）, the manifestation rate of surface airway,the occurrence rate of emphysema and ＂the mosaic infusion＂ is higher than the contrast group with the notable diffirence by statistics （ P 〈 0.01）. Conclusion：The pathologic changes of COPD can be kown through HRCT performance, together with the check of lung function, by learning the development of illness. We can have a better choice for the clinical therapetitic schedule.