戒烟后COPD患者肺气肿CT定量指标变化的纵向研究

Longitudinal study of CT quantitative indicators of emphysema in COPD patients after smoking cessation

目的利用CT定量分析技术纵向观察戒烟后慢性阻塞性肺疾病(COPD)患者肺气肿定量指标的变化情况。方法回顾性收集"数字肺"数据库中心COPD患者130例(前后行胸部CT检查2次、间隔2年),按吸烟现状分为不吸烟组、吸烟组、戒烟组,戒烟组按戒烟时限又分为短期戒烟组和长期戒烟组。采用"数字肺"肺气肿定量软件分析COPD患者的两肺体积、PD15、两肺%LAA-950和各肺叶%LAA-950。各组中比较前后两次肺气肿的定量指标的差异。结果不吸烟组的第二次右肺下叶%LAA-950高于第一次(P<0.05),吸烟组第二次两肺和两肺上叶%LAA-950高于第一次(P<0.05),戒烟组中,第二次右肺中叶%LAA-950高于第一次(P<0.05);短期戒烟组中第二次两肺和右肺中叶%LAA-950高于第一次(P<0.05),长期戒烟组中前后两次肺气肿的定量指标无统计学差异(P>0.05)。结论 CT定量分析可直观显示戒烟后COPD患者肺气肿定量指标的变化情况,戒烟能延缓肺气肿的进展。

Objective To make a longitudinal investigation on the changes in quantitative indicators of emphysema in patients with chronic obstructive pulmonary disease(COPD)after smoking cessation based on CT quantitative technique.Methods A retrospective collection of 130 patients with COPD in the Digital Lung 1 Database Center(2 times of chest CT scanning at an interval of 2 years),according to the current smoking status,were divided into non-smoking group,smoking group,smoking cessation group,and smoking cessation group according to the smoking cessation time limit,were divided into short-term smoking cessation group and long-term smoking cessation group.Two lung volumes,PD15,two lung%LAA-950,and each lung lobe%LAA-950 were analyzed using the digital lung emphysema quantitative software.Differences in quantitative indicators of emphysema before and after smoking cessation were compared between the groups.Results In the non-smoking group,the right lower lobe%LAA-950 at the second time was higher than that at the first time(P<0.05).In the smoking group,the two lungs and the upper lobe of the lungs%LAA-950 in the second time were higher than those in the first time(P<0.05).In the smoking cessation group,the right lung mid-lobe%LAA-950 at the second time was higher than that at the first time(P<0.05).In the short-term group of smoking cessation,the two lungs and the right mid-lobe%LAA-950 at the second time were higher than those at the first time(P<0.05).The quantitative indicators of emphysema in the long-term smoking cessation group were not significantly different(P>0.05).Conclusion CT quantitative analysis can visually show the changes in quantitative indicators of emphysema in COPD patients after smoking cessation,and smoking cessation can effectively delay the progression of emphysema.