支气管扩张症肺功能变化与高分辨率CT评分的关系

Correlation between pulmonary function tests and high resolution computed tomography in bronchiectasis

目的探讨支气管扩张症肺功能变化与高分辨率CT(high resolutioncomputed tomography,HRCT)评分的相关性。方法收集胸部HRCT诊断的支气管扩张症稳定期患者86例,进行肺功能检查和HRCT评分,并分析两者关系及不同类型支气管扩张症的肺功能差异。结果肺功能为第1秒用力呼气容积占预计值百分比(FEV1%pred)(53.6±25.2)%,用力肺活量占预计值百分比(FVC%pred)(62.7±17.9)%,FEV1/FVC(61.5±12.6)%,弥散功能占预计值百分比(DLCO%pred)(73.6±13.8)%;HRCT评分显示,支气管扩张症分布范围为(8.276±5.915)分、扩张程度为(7.151±4.306)分、管壁厚度为(5.705±2.829)分。支气管扩张症分布范围与FEV1%pred、FVC%pred、FEV1/FVC、DLCO%pred均呈明显负相关(均P<0.05);扩张程度仅与FEV1%pred呈负相关,管壁厚度与FEV1%pred、DLCO%pred呈负相关。各类型的肺功能表现不一。结论肺通气功能与HRCT评分密切相关,其中与扩张分布范围相关性最为明显;而囊状支气管扩张症肺功能受损是最严重的。

Objective To investigate the correlation between pulmonary function tests （PFT） and high resolution computed tomography（HRCT） in bronchiectasis. Methods Spirometry and CT score including the number of bronchiectatic segments, bronchial dilatation and bronchial wall thickening were collected in 86 patients with bronchiectasis diagnosed by HRCT. Analysis was conducted on the correlation between PFT and HRCT, the differences of pulmonary function in the different types of bronchiectasis. Results The FEV1% pred, FVC% pred, FEV1/FVC, and DLco%pred values were （53.6±25.2）%,（62.7±17.9）%,（61.5±12.6）%,（73.6±13.8）% respectively. CT revealed that CT scores for the number of bronchiectatic segments, bronchial dilatation and bronchial wall thickening were （8. 276 ± 5. 915） scores, （7. 151 ± 4. 306） scores and （5. 705 ± 2. 829） scores, respectively. The number of bronchiectatic segments significantly negatively correlated with FEV1% pred, FVC% pred, FEV1/FVC and DLco% pred, respectively（ P 〈0.05）. Bronchial dilatation just correlated with FEV1 % pred, and bronchial wall thickening had negative correlation with FEV1%pred and DLco % pred. There were differences of pulmonary function in the different types of bronchiectasis. Conclusion There is significant correlation between pulmonary function and HRCT in patients with bronchiectasis. The number of bronchiectatic segments is the most important. Cystic bronchiectasis seems to be the most severe form of bronchiectasis.