320排CT低剂量呼吸双相扫描在慢性阻塞性肺疾病急性加重期患者肺叶容积评价中的应用

Application of 320 row CT low-dose dual phase breath scan in evaluation of pulmonary volume in patients with acute exacerbation of COPD

目的通过定量测量慢性阻塞性肺疾病(COPD)急性加重期及缓解期患者全肺、单侧肺、各肺叶深吸气相及深呼气相肺容积指标,探讨320排容积CT低剂量呼吸双相扫描对COPD急性加重期患者肺功能的评估价值。方法收集我院呼吸内科就诊的急性加重期COPD患者35例、缓解期COPD患者30例,均行320排低剂量胸部最大深吸气末、最大深呼气末CT扫描。分割最大深吸气末及深呼气末各肺叶容积(Vin,Vex),分别计算各肺叶呼吸两相容积差Vin-Vex,容积变化率(Vin-Vex)/Vin。分析2组患者呼吸双相肺容积指标间的差异。结果急性加重期组与缓解期组CT容积指标比较,吸气相全肺、右肺、右肺中叶、右肺下叶、左肺下叶差异有统计学意义(t=2.607、2.977、2.284、3.626、3.233,P<0.05),呼气相右肺、右下肺、左肺、左下肺差异均有统计学意义(t=3.734、2.583、2.646、3.401,P<0.05);2组各肺叶容积差Vin-Vex比较,右肺、右肺下叶、左肺下叶差异有统计学意义(t=3.966、3.428、2.041,P<0.05);2组各肺叶容积变化率(Vin-Vex)/Vin比较,仅双肺下叶差异有统计学意义(t=3.522、4.152,P<0.05)。结论 320排容积CT各肺叶容积测定可以预测患者急性加重期肺功能情况。

Objective To investigate the value of 320 row volume CT low-dose scanning in evaluating the lung function of patients with acute exacerbation of COPD by quantitative measurement of the whole lung, unilateral lung,pulmonary deep inspiratory phase and deep expiratory lung volume index in patients with acute exacerbation and remission of COPD. Methods Thirty-five cases with acute exacerbation of COPD patients and 30 cases with remission COPD patients were undergone with 320 slice low-dose chests in deep inspiratory and deep end expiratory CT scan.The two phases of inspiratory and expiratory lung volume were divided（Vin, Vex）, calculate the difference of the two phases（Vin-Vex）, and the volume change rate（Vin-Vex/Vin）. To analyze the differences between the two groups.Results Compare CT volume index of two groups. Inspiratory phase were showed as： the whole lung, right lung, right middle lobe, right lower lobe, lower lobe of left lung had statistically significant between the two groups（t=2.607,2.977, 2.284, 3.626, 3.233, P0.05）. Expiratory phase were showed as： the lung, right lung, right middle, right lower lung had statistically significant between the two groups,（t=3.734、2.583、2.646、3.401, P0.05）. The volume difference of the two phases were showed as： right lung, right lower lobe, left lower lobe had statistically significant between the two groups（t=3.966、3.428、2.041, P0.05）. The volume change rate showed double lower lobe had statistically significant between the two groups（t=3.522、4.152, P0.05）. Conclusion Determination of 320 slice volume CT lung volume can predict lung function in patients with acute exacerbation.