CT定量测量COPD患者肺小血管横断面积与肺气肿的相关性研究

CT Quantitative Measurement of Patients with COPD Pulmonary Small Vessels Cross Sectional Area of Correlation Study with Emphysema

目的:研究CT测量段和亚段肺血管横断面积,评估总血管横断面积与肺气肿和气道阻塞的相关性,同时,COPD存在表型和肺血管横断面的对评估血管改变差异。方法:收集医院2012年6月-2016年1月191例COPD患者。平均年龄(62±5)岁。所有患者有吸烟病史,平均数量为(52±29)包/年。应用CT测量肺血管横断面积,采用三个层面进行测量,分别为:主动脉弓上缘1cm层面、支气管隆突下1cm层面及右肺下静脉下1cm层面,并取平均值。结果:%CSA<5与%LAA-950具有显著负相关性(r=-0.83,p<0.0001),%CSA5-10与%LAA-950具有较弱的相关性(r=-0.25,p=0.0004)。%CSA<5与FEV1%(r=0.29,p<0.0001)和FEV1/FVC(r=0.45,p<0.0001)具有显著相关性。%CSA5–10与FEV1%和FEV1/FVC弱的正相关性。47例表现支气管表型(平均%LAA-950:2.6%±1.2),83例表现为肺气肿表型(平均%LAA-950:13.6%±6.9)。GOLD组中,COPD患者表型间无统计学差异(p=0.835)。结论:肺气肿程度与小于5mm^2肺小血管总%CSA具有显著相关性,而与气道受限相关性较弱。因此这一结果表明COPD患者肺气肿与血管改变具有相关性,也表明肺气肿能够损坏血管结构。

Abstract Objective： To study the CT measurement period and the period of pulmonary vascular cross sectional area, to assess the total vascular cross sectional area, and the correlation of emphysema and airway obstruction, at the same time, COPD phenotype and pulmonary vascular assessment of vascular changes of cross-sectional differences. Methods： Collect 2012.6-2016.1, in our hospital 191 cases of patients with COPD.The average age（62±5）years. All patients with a history of smoking, the average number of （52±29） package/years. Application of CT measurement of pulmonary vascular cross sectional area, adopting the measure in three dimensions, respectively： aortic arch on margin of 1 cm, bronchial subcarinal 1 cm and right pulmonary veins under 1 cm level, and average. Results： %CSA〈5 and LAA-950 has a significantly negative correlation （r=-0.83, p〈0.0001）, %CSA5-10and%LAA-950 has weak correlation （r=-0.25, p=0.0004）.%CSA〈5with FEV1%（r=0.29, p〈0.0001） and FEV1/FVC（r=0.45, p〈0.0001） has significant correlation.%CSA5-10 and FEV1 and FEV1/FVC weak positive correlation. 47 cases of bronchus phenotypic performance （%LAA-950： an average of 2.6% plus or minus 1.2）, 83 cases of pulmonary emphysema phenotype （%LAA-950： an average of 13.6% plus or minus 6.9）.GOLD group, no statistical difference between patients with COPD phenotype （p=0.835）.Conclusion： The degree of emphysema with less than 5mm2 small blood vessels was lung %CSA has significant correlation, and weak correlation with airway is limited.Therefore, the results showed that patients with COPD emphysema associated with vascular changes and structure also suggests emphysema can damage blood vessels.