HRCT评价COPD剑鞘样气管指数与肺功能的相关性研究

Relationship between Sheath-like trachea Index in Chronic Obstructive Pulmonary Disease(COPD) with lung function assessed by high resolution CT(HRCT)

目的应用HRCT探讨慢性阻塞性肺疾病(chronic objective pulmonary disease,COPD)患者剑鞘样气管指数与肺功能检查结果的相关性。方法从129例经临床诊断为COPD并全部行HRCT和肺功能检查的患者中,根据剑鞘样气管的评定标准,从中选出具有剑鞘样气管改变的患者30例。按照COPD临床严重度分级,其中0级患者5例,1级患者7例,2级患者8例,3级患者6例,4级患者4例。在PASC系统软件上测量其内冠状径、矢状径,计算出气管指数。分析其与肺功能的相关性。结果剑鞘样气管内冠状径的长度范围是7.0～15.7 mm,均值为(11.8±2.2)mm,内矢状径的长度范围是17.2～25.4 mm,均值为(21.3±2.2)mm,气管指数范围是0.33～0.67,均值为0.56±0.10。剑鞘样气管指数与FEV1/FVC%呈正相关,(r=0.50,P<0.01)、与FEV1呈正相关(r=0.42,P<0.05),与患者临床严重度分级呈负相关(r=-0.38,P<0.05),与FVC、FRC、TLC、RV、RV/TLC无相关性。结论 HRCT可以精确测量其气管指数,可作为评估气流受限较敏感的指标。

Objective To assess the relationship between Sheath-like trachea Index in Chronic Obstructive Pulmonary Disease with lung function by high resolution CT（HRCT）.Methods 30 patients of the trachea with a sheath-like change were selected from 147 patients with clinical diagnosis of COPD who were examined by HRCT and pulmonary function,according to the sheath-like trachea assessment criteria.Classification according to clinical severity of COPD,0 level was in 5 cases,1 level in 7 cases,2 level in 8 cases,3 level in 6 cases,and 4 level in 4 cases.The internal coronal and sagittal diameters of the trachea were measured in the PACS system software,and the index of trachea was calculated out.Ralationship were assessed between the measurements and lung function.Results The internal coronal diameter ranged from 7.0 to 15.7mm,with an average of（11.8±2.2） mm,while the internal sagittal diameter rangered from 17.2 to 25.4 mm,with an average of（21.3±2.2） mm.The tracheal index ranged from 0.33 to 0.67,with an average of 0.56±0.10.The tracheal index was positively correlated with FEV1/FVC%（r=0.50,P0.01） and FEV1（r=0.42,P0.05）,was negatively correlated with clinical classification of patients with COPD（r=-0.38,P0.05）,and wasn,tcorrelated with FVC,FRC,TLC、RV and RV/TLC.Conclusion HRCT could accurately and intuitively diagnose scabbard-like trachea.The tracheal index can be used as a sensitive parameter in the evaluation of airflow limitation.