慢阻肺患者HRCT肺气肿定量分析与疾病严重程度的相关性研究

Correlation Between HRCT Emphysema Quantitative Analysis and Disease Severity in Patients with Chronic Obstructive Pulmonary Disease

目的探讨高分辨CT(HRCT)肺气肿定量分析对慢性阻塞性肺疾病(慢阻肺,COPD)患者疾病严重程度的预测价值。方法选取我院随访的稳定期慢阻肺患者,行HRCT检查及肺功能检查,应用相关软件处理全肺容积、肺气肿体积,并计算既定阈值下(-950HU、-910HU)低衰减区域比例(LAA%),完成CAT评分表、SGRQ问卷,及改良英国医学研究委员会(mMRC)呼吸困难量表,测量患者6分钟步行距离及BMI,计算BODE指数。结果共46例稳定期慢阻肺患者纳入本研究,吸气相(-950HU)LAA%与FEV1%预计值、FEVl/FVC呈负相关,与RV、RV/TLC呈正相关;呼气相(-950HU)LAA%与FEVl/FVC呈负相关,与RV和RV/TLC呈正相关;吸气相(-910HU)LAA%与FEVl/FVC呈负相关,与RV、RV/TLC呈正相关;呼气相(-910HU)LAA%与FEVl/FVC呈负相关,与RV和RV/TLC呈正相关;呼吸双相(-950HU、-910HU)LAA%与BODE指数均成正相关。结论HRCT肺气肿定量分析LAA%与患者FEV1%预计值及BODE指数等反应疾病严重程度指标相关,其可以作为评估慢阻肺病情严重度的重要辅助指标。

Objective To explore predictive value of quantitative emphysema analysis on high-resolution computed tomography(HRCT)for disease severity in patients with chronic obstructive pulmonary disease(COPD).Methods Patients with stable chronic obstructive pulmonary disease followed up by our hospital were selected for HRCT and pulmonary function tests.Related software was used to process total lung volume,emphysema volume.The low attenuation area ratio(LAA%)under established threshold(-950HU,-910HU)was calculated.CAT score sheet,SGRQ questionnaire,and modified British medical research council(mMRC)dyspnea scale were completed.The 6-minute walking distance(6MWD)and BMI were measured,and BODE index was calculated.Results 46 patients with stable COPD were included.Inspiratory phase(-950HU)LAA%was negatively correlated with predicted FEV1%and FEVl/FVC,and was positively correlated with RV and RV/TLC.Exspiratory phase(-950HU)LAA%was negatively correlated with FEVl/FVC and positively correlated with RV and RV/TLC.Inspiratory phase(-910HU)LAA%was negatively correlated with FEVl/FVC and positively correlated with RV and RV/TLC.Expiratory phase(-910HU)LAA%was negatively correlated with FEVl/FVC,and positively correlated with RV and RV/TLC.Respiratory biphasic(-950HU、-910HU)LAA%was positively correlated with BODE index.Conclusion Quantitative analysis of LAA%in HRCT emphysema would be related to patients'disease severity indicators such as FEV1%predicted value and BODE index,which could be used as an important auxiliary indicator to evaluate COPD severity.