慢性阻塞性肺疾病的 CT 特征与肺功能的相关性研究

The correlation between CT features and pulmonary function of chronic obstructive pulmonary disease

目的：探讨不同慢性阻塞性肺疾病（COPD）CT 特征与肺功能指标的相关性。方法收集COPD 患者80例，通过肺功能仪检测（PFT）和多层螺旋 CT（MSCT）检查，分析其 COPD CT 特征（像素指数）与肺功能指标[1秒用力呼气容积（FEV1）、第1秒用力呼气容积占用力肺活量百分比（FEV1／FVC）、残气／肺总量比（RV ／TLC）]的相关性。结果根据 CT 测量肺密度减低区域面积（LAA％）和气道壁厚度／管腔面积，将COPD 分为肺气肿表型56例、气道表型13例和混合表型11例，肺气肿表型像素指数、FEV1、FEV1／FVC、RV ／TLC 分别为27．68％、（32．19±16．78）％、（43．69±11．23）、（55．67±15．49），气道表型分别为5．23％、（55．67±23．12）％、（52．30±10．67）、（49．48±13．27），混合表型分别为22．47％、（41．23±12．55）％、（47．31±9．98）、（54．19±16．29），像素指数、FEV1、FEV1／FVC、RV ／TLC 在 COPD CT 不同表型间差异均有统计学意义（χ2＝19．013，F ＝6．234、7．854、6．389，均 P ＜0．05）；肺气肿表型和气道表型中像素指数与 FEV1和FEV1／FVC 呈负相关（r ＝－0．67、－0．94、－0．55、－0．42，均 P ＜0．05），与 RV ／TLC 呈现正相关关系（r ＝0.57、0．37，均 P ＜0．05）；混合表型中像素指数与 FEV1、FEV1／FVC 和 RV ／TLC 均无明显相关关系（r ＝－0.56、－0．27、0．32，均 P ＞0．05）。结论CT 特征可以作为诊断 COPD 分类和治疗效果参考依据，主要在肺气肿表型和气道表型中 PFT 复查意义较大。

Objective To study the correlation between CT features and pulmonary function indexes in dif-ferent chronic obstructive pulmonary diseases（COPD）.Methods Collection of COPD patients with 80 cases were collected,,the correlation analysis of COPD CT features （pixel index）and pulmonary function,including one second forced expiratory volume （FEV1 ）,one second forced expiratory volume accounted for the percentage of forced vital capacity （FVC）and residual volume /lung total ratio （RV /TLC）were examined by pulmonary function testing （PFT）and multislice spiral CT （MSCT）.Results According to CT,the regional area of lung density （LAA%）and airway wall thickness/lumen area were measured,COPD was divided into 56 cases of emphysema phenotype,13 case of airway phenotype and 11 case of mixed phenotype.The emphysema phenotype index,FEV1 ,FEV1 /FVC pixels,RV /TLC =27.68%,（32.19 ±16.78）%,（43.69 ±11.23）,（55.67 ±15.49 ）,airway phenotype were 5.23%, （55.67 ±23.12）%,（52.30 ±10.67）,（49.48 ±13.27）,respectively,mixed phenotype were 22.47% （41.23 ± 12.55）%,（47.31 ±9.98）,（54.19 ±16.29）,FEV1 ,FEV1 /FVC,pixel index,RV /TLC COPD CT in different phe-notypic differences were statistically significant （χ2 =19.013,F =6.234,7.854,6.389,all P 〈0.05）.The emphyse-ma phenotype and airway phenotype in pixel index and FEV1 and FEV1 /FVC were negative correlation （r =-0.67,-0.94,-0.55,-0.42,all P 〈0.05）,showed a positive correlation with RV /TLC （r =0.57,0.37,all P 〈0.05）. Mixed pixel phenotype index and FEV1 ,FEV1 /FVC and RV /TLC were not significantly correlated （r =-0.56,-0.27,0.32,all P 〉0.05）.Conclusion CT features can be regarded as the reference to diagnosis the COPD pheno-type and evaluate the effect of treatment,it is necessary to re -examine PFT in emphysema and airway phenotypes.