慢性阻塞性肺疾病患者肺功能与高分辨率CT影像学的相关性

Correlation between pulmonary function and HRCT imaging in patients with COPD

【目的】观察不同程度慢性阻塞性肺疾病患者肺功能和小气道指标的变化及相关性,探讨应用HRCT和肺功能联合评价COPD的方法。【方法】受试者依据肺功能指标(FEV1、FEV1/FVC)分为轻度COPD组、中度COPD组、重度COPD组及正常对照组。用肺功能仪测试FEV1、FEV1/FVC、MMEF75/25、TLCOSB;用HRCT扫描胸部,测算T/D、WA%等指标。【结果】(1)与正常对照组比较,轻度COPD组、中度COPD组及重度COPD组的FEV1、FEV1/FVC、MMEF75/25、TLCOSB均有显著性差异(P<0.01)。(2)与正常对照组比较,轻度COPD组的外周气道T/D、WA%、中度COPD组和重度COPD组的外周气道T/D、WA%,中央气道T/D、WA%均有显著性差异(P<0.01),且有随病情加重升高的趋势。(3)FEVI、FEV1/FVC、MMEF75/25、TLCOSB与外周气道T/D、WA%,中央气道T/D、WA%呈负相关(P<0.01)。【结论】HRCT及肺功能检查可作为定量评价COPD的方法,且能提示疾病的严重程度。

【Objective】To observe the changes and correlation between pulmonary function and small airway indexes in patients with different degrees of chronic obstructive pulmonary disease（COPD）, and explore the methods for evaluating COPD by high resolution computed tomography（HRCT） combined with pulmonary function.【Methods】According to the pulmonary function indexes（FEV1,FEV1/FVC）, the subjects were divided into mild COPD group, moderate COPD group, severe COPD group and control group. Forced expiratory volume in one second（FEV1）, the ratio of FEV1 to forced vital capacity（FEV1/FVC）, maximal mid expiratory flow（MMEF75/25） and TLCOSB were tested by pulmonary function instrument. The chest was scanned by HRCT, then the ratio of airway wall thickness and airway diameter（T/D） and the percentage of airway wall area in total airway cross-sectional area（WA%） were calculated.【Results】（1）Compared with the control group, the difference of FEV1, FEV1/FVC, MMEF75/25 and TLCOSB was significant in mild COPD group, moderate COPD group and severe COPD group（P〈0.01）.（2）Compared with the control group, the T/D and WA% of peripheral airways in mild COPD group, as well as the T/D and WA% of peripheral and central airways in moderate COPD group and severe COPD group were significantly different（P〈0.01）. There was an increasing trend with the aggravation of disease.（3）FEVI, FEV1/FVC, MMEF75/25 and TLCOSB were negatively correlated with T/D and WA% of peripheral airways as well as T/D and WA% of central airways（P〈0.01）.【Conclusion】HRCT and pulmonary function test can be the quantitative methods for evaluating COPD, and may indicate the severity of disease.