慢性阻塞性肺疾病患者呼吸双相高分辨率 CT肺定量指标与肺功能的相关性研究

Correlation between pulmonary quantitative indicators on high-resolution CT and pulmonary function in patients with chronic obstructive pulmonary disease

目的：探讨慢性阻塞性肺疾病（COPD）患者中呼吸双相高分辨率CT肺定量指标与肺功能检查各项指标的相关性。方法将54例COPD患者按照病变严重程度分为轻度组5例、中度组21例、重度组19例及极重度组9例，四组均行呼吸双相全肺高分辨率CT检查，检测深吸气末、深呼气末肺密度、呼吸双相肺密度差及肺容积，分析肺密度与肺容积和肺功能各指标的相关性。结果四组患者深吸气末与深呼气末肺密度差异均有统计学意义（t＝13．67、9．89，均P＜0．05）；四组第1秒用力呼气量（FEV1）、用力肺活量（FVC）及FEV1／FVC比值差异均有统计学意义（t＝1．15、0．89、7．89、13．76、16．67，均P＜0．05）；随COPD严重程度的增加，深吸气末与深呼气末肺容积均相应增加，但四组间差异均无统计学意义（t＝15．46、13．28、11．47，均P＞0．05）；胸部重建后深吸气末及深呼气末肺容积与FEV1、FVC、FEV1／FVC有明显相关性（r＝－0．071、－0．083，r＝－0．713、－0．542，r＝－0．622、0．639，均P＜0．05）；深呼气末肺容积与残气量占最大肺总量百分比预计值间有明显相关性（r＝0．622，P＜0．05）；深吸气相肺密度与FEV1／FVC、残气量值有明显相关性（r＝0．539，P＜0．05）。结论 COPD患者的呼吸双相高分辨率螺旋CT的肺定量指标与肺功能检测指标间具有良好的相关性，可用于评价COPD严重程度。

Objective To study the relationship between pulmonary quantitative indicators on 64-slice spiral CT and lung function,and the diagnosis value of breathing bipolar lung CT scan to emphysema.Methods 54 chronic obstructive pulmonary disease patients were divided into the mild group （n =5）, moderate group （n =21）, severe group（n=19） and gravely severe group（n=9）.Four groups received breathing bipolar total lung high-resolution CT scan to test lung density at the end of deep inspiration and expiration,breathing bipolar lung density difference and lung volume,and the relationship between lung density/volume and lung function indicators were analyzed.Results There were significant differences in lung density at the end of deep inspiration and expiration（t=13.67,9.89,all P〈0.05）,the forced expiratory volume in one second（FEV1）,forced vital capacity（FVC）and FEV1/FVC among these fourgroups（t=1.15,0.89,7.89,13.76,16.67,all P〈0.05）.The lung volume at the end of inspiration and expiration increased with the severity of disease,while there were no significant differences among these four groups （t=15.46,13.28,11.47,all P〉0.05）.The lung volumes at the end of deep inspiration and expiration were obvi-ously correlated with FVC,FEV1 and FEV1/FVC（r=-0.071,-0.083,r=-0.713,-0.542,r=-0.622,0.639, all P〈0.05） .The lung volume at the end of deep expiration was obviously correlated with the expected ratio of resid-ual volume to maximum total lung capacity（r=0.622,P〈0.05）.The deep aspiratory phase lung density was closely correlated with FEV1/FVC and residual volume（r=0.539,P〈0.05）.Conclusion Pulmonary quantitative indica-tors on 64-slice spiral CT and pulmonary function has good correlation,which can be used to evaluate the severity of emphysema in patients with chronic obstructive pulmonary disease.