低剂量CT扫描及肺功能检查对COPD小气道参数的研究

The application of low dose CT scan and lung function examination on airway remodeling in patients with chronic obstructive pulmonary disease

目的探讨低剂量CT扫描和肺功能检查在评价COPD患者气道重塑方面的作用和关系。方法选取COPD患者60例为观察组,同时选择与观察组患者年龄匹配的健康体检者30例为对照组。应用低剂量CT扫描并观察患者肺部影像学表现,运用后处理软件测量COPD患者气道壁厚度(T)、气道壁面积(WA)及气道外径(D)等参数,评估气道重塑的程度。结果1)实验组支气管管壁厚度与外径比值的2倍(2T/D)和管壁横断面积占支气管总面积的百分比(WA%)显著高于对照组(P<0.01),差异有统计学意义;2)对照组肺功能指标(FEV1/预计值)%、(FEV1/FVC)%显著大于观察组(P<0.01),差异具有统计学意义;3)经直线相关分析,观察组患者FEV1%与(2T/D)成负相关(P<0.01);与WA%成负相关(P<0.01)。结论低剂量CT扫描在评估COPD气道重塑方面具有非常高的准确性,肺功能指标(FEV1/预计值)%、(FEV1/FVC)%与COPD患者气道重塑关系密切。

Objective Low-dose CT scanning was adopted to observe the chronic obstructive pulmonary disease(COPD)patients of airway remodeling,so as to investigate the effect of low-dose CT scanning and pulmonary function examination in the evaluation of airway remodeling in patients with COPD.Methods We selected 60 patients with COPD as the experimental group,and 30 age-matched healthy patients were selected as the control group at the same time.Low-dose CT scanning was used to observe the pulmonary imaging findings.The airway wall thickness(T),airway wall area(WA)and airway outer diameter(D)were measured by post-processing software to evaluate the extent of airway remodeling in COPD patients.Results 1)In the group of COPD,the ratio of bronchial wall thickness to outer diameter was 2 times(2T/D)and the cross-sectional area of wall tube(WA%)was significantly higher than that of control group(P<0.01),and the difference was statistically significant;2)The predictive value of pulmonary function index(FEV1%),(FEV1/FVC)%in the control group was significantly greater than that in the COPD group(P<0.01),and the difference was statistically significant;3)Linear correlation analysis showed there was a negative correlation between FEV1%and(2T/D)(P<0.01),and negatively correlated with WA%(P<0.01)in the group of COPD.Conclusion The predictive value of pulmonary function,(FEV1/FVC)%,and airway remodeling in patients with COPD are closely related to FEV1.So,Low-dose CT scan has very high accuracy in evaluating airway remodeling in COPD.