HRCT及定量CT对慢性阻塞性肺疾病早期诊断价值的研究

Value of HRCT and quantitative CT in early diagnosis of chronic obstructive pulmonary disease

目的探讨HRCT及定量CT对慢性阻塞性肺疾病(COPD)早期诊断价值。方法收集2016年8月~2017年10月浙江温岭市中医院呼吸内科收治的COPD患者100例为观察组,另健康体检者60例为对照组,所有研究对象均接受肺通气功能检查。观察组入院3天内行HRCT容积扫描,图像传输至工作站,记录肺容积、肺密度各项参数。结果观察组FEV1、FVC、FEV1/FVC、FEV1%明显低于对照组,RV/TLC明显高于对照组,差异有统计学意义(P <0.05)。与COPDⅠ级患者比较,COPDⅡ级患者深吸气末肺密度和深呼气末肺密度明显变深,Vin、TEV及EI明显升高,差异有统计学意义(P <0.05);Ⅰ级与Ⅱ级患者Vex和TLV比较,差异无统计学意义(P> 0.05)。结论 HRCT及定量CT对早期COPD有较好的诊断价值,可鉴别诊断COPDⅠ级与Ⅱ级,对评定早期COPD患者有重要价值。

Objective To explore the value of HRCT and quantitative CT in early diagnosis of chronic obstructive pulmonary disease(COPD). Methods 100 COPD patients admitted to Department of Respiratory Medicine of Wenling Hospital of Traditional Chinese Medicine in Zhejiang Province from August 2016 to October 2017 were selected as the observation group,and 60 healthy people as the control group.All the subjects were examined for pulmonary ventilation function.The observation group was given HRCT volume scan within 3 days after admission,and the image was transmitted to the workstation to record the parameters of lung volume and lung density. Results FEV1,FVC,FEV1/FVC and FEV1% in the observation group were significantly lower than those in the control group,and RV/TLC was significantly higher than those in the control group,with statistical significance(P < 0.05).Compared with COPD grade Ⅰ patients,COPD grade Ⅱ patients had significantly deeper end-inspiratory lung density and higher end-expiratory lung density,Vin,TEV and EI(P < 0.05).There was no significant difference between COPD grade Ⅰ patients and COPD grade Ⅱ patients in Vex and TLV(P > 0.05). Conclusion HRCT and quantitative CT have better diagnostic value for early COPD.They can differentiate COPD grade Ⅰ from grade Ⅱ and have important value for evaluating early COPD patients.