双源CT肺容积测定在支气管哮喘患者支气管舒张试验中的应用价值

Application Value of Dual Source CT Lung Volume Measurement in Patients With Bronchial Asthma in Bronchial Dilation Test

目的探讨双源CT(DSCT)的容积指标与支气管哮喘患者支气管舒张试验(BDT)中肺功能指标的相关性,评估其在支气管舒张试验中的价值。方法选择BDT阳性的哮喘急性发作患者70例为哮喘组,BDT阴性的50例作对照组,在BDT前后进行双相HRCT扫描,比较BDT前后两组DSCT各项容积指标的差异及动态变化,分析其与肺功能指标的相关性。结果与对照组比较,哮喘组BDT前最大呼气末容积、BDT前后最大呼气末容积差值的绝对值及最大呼气末容积变异率均增高(P<0.01)。经相关性分析显示,最大呼气末容积、最大呼气末容积变异率与△FEV1、FEV1变异率有显著相关(P<0.01),最大呼气末容积变异率与BDT前后的FEV1/FVC及变异率、FEV1%预_后多项指标具有相关性。结论支气管舒张试验前后,DSCT肺容积指标动态变化与肺功能指标具有相关性,能够有效评估支气管哮喘患者肺功能,对诊断哮喘具有重要意义。

Objective To investigate the relationship of dual-source CT （DSCT） lung volume indexes with lung function indexes in patients with bronchial asthma in bronchial dilation test（BDT）,and to assess its value in BDT. Methods 70 cases of patients with bronchial asthma of acute stage with positive results of BDT were selected as asthma group. 50 cases of patients with negative results of BDT were selected as control group. All patients underwent dual phase dual-source CT scans before and after BDT. The volume indexes and changes between the two groups were compared, and the correlation with PFT indexes were analyzed. Results The volume at maximum expiration before BDT, the absolute value of the volume difference at maximum expiration before and after BDT, the volume variation rate at maximum expiration of asthma group were significantly higher than control group （P〈0.01）. The correlation analysis showed that, the volume at maximum expiration, the volume variation rate at maximum expiration have significant correlations with △ FEV1 and FEV1 mutation rate （P〈0.01）.The volume variation rate at maximum expiration has correlation with mang indexes such as FEV1/FVC before and after BDT, FEV1/FVC variation rate, FEV1%pre after. Conclusion The dualsource CT lung volume indexes and dynamic changes before and after BDT have correlations with lung function indexes, and can effectively assess the pulmonary function of bronchial asthma patients, which is important to the diagnosis of asthma.