多排螺旋CT定量测量对慢性阻塞性肺疾病病情诊断的临床价值

Clinical Value of Multi-slice Spiral CT Quantitative Measurement in the Diagnosis of Chronic Obstructive Pulmonary Disease

目的研究多排螺旋CT定量测量肺气肿容积比例对慢性阻塞性肺疾病肺功能的诊断价值。方法随机选择2011年1月至2019年1月确诊为COPD的患者102例,以及同期怀疑COPD而确诊为非COPD的患者38例。所有患者均进行常规肺功能检查和320排螺旋CT肺容积扫描检测,分析CT测量E/L与肺功能实验室指标均的关系。结果COPD患者FEV1(实际/预计)和FEV1/VCmax显著低于非COPD患者(P<0.05),RV(实际/预计)、TLC(实际/预计)、RV/TLC、全肺E/L、右肺E/L以及左肺E/L均显著高于非COPD患者(P<0.05);COPD患者全肺E/L、右肺E/L以及左肺E/L均随肺功能分级升高而升高,与FEV1(实际/预计)和FEV1/VCmax成负相关关系(P<0.05),与RV(实际/预计)、TLC(实际/预计)、RV/TLC均呈正相关关系(P<0.05)。结论CT测量的COPD肺气肿容积比例与肺功能有关,可以作为COPD患者肺功能评价的指标。

Objective To study the diagnostic value of quantitative measurement of pulmonary emphysema volume ratio by multi-slice spiral CT in pulmonary function of chronic obstructive pulmonary disease(COPD).Methods 102 patients with COPD were randomly selected from January 2011 to January 2019,and 38 patients with suspected COPD were diagnosed as non-COPD.All patients underwent routine pulmonary function tests and 320-slice spiral CT lung volume scanning.The relationship between E/L measured by CT and pulmonary function laboratory indexes was analyzed.Results FEV1(actual/predicted)and FEV1/VCmax in COPD patients were significantly lower than those in non-COPD patients(P<0.05),RV(actual/predicted),TLC(actual/predicted),RV/TLC,whole lung E/L,right lung E/L and left lung E/L in COPD patients were significantly higher than those in non-COPD patients(P<0.05).The whole lung E/L,right lung E/L and left lung E/L in COPD patients elevated with higher pulmonary function grade,and increased with FEV1(actual/predicted)and FEV1/max.Negative correlation(P<0.05),positive correlation with RV(actual/expected),TLC(actual/expected),RV/TLC(P<0.05).Conclusion The volume ratio of COPD emphysema measured by CT is related to pulmonary function and can be used as an index for evaluating the pulmonary function of COPD patients.