螺旋CT在老年慢性阻塞性肺疾病急性期小气道诊断中的临床应用

Clinical Application of Spiral CT in the Diagnosis of Small Airway in the Acute Stage of Chronic Obstructive Pulmonary Disease in the Elderly

目的:探讨螺旋CT在老年慢性阻塞性肺疾病(COPD)急性期小气道诊断中的临床应用。方法:回顾性选取2020年2月-2021年2月九江市第一人民医院老年COPD急性期患者50例作为肺疾病急性期组、心肺功能正常体检者50例为心肺功能正常组。两组均行螺旋CT检查,统计分析两组支气管管壁测量结果,并统计分析肺疾病急性期组不同疾病严重程度患者的支气管管壁测量结果,分析肺疾病急性期组患者的支气管管壁测量结果和肺功能的相关性。结果:肺疾病急性期组支气管右肺上叶尖段管壁气道壁厚度(WT)大于心肺功能正常组,气道壁厚度/气道外径(TDR)低于心肺功能正常组(P<0.05);肺疾病急性期组支气管右肺上叶亚尖段管壁WT、WA均大于心肺功能正常组,TDR低于心肺功能正常组(P<0.05)。肺疾病急性期组重度、极重度患者的支气管右肺上叶尖段管壁WT、WA均大于轻度、中度患者,TDR均高于轻度、中度患者(P<0.05);极重度患者的支气管右肺上叶尖段管壁WT大于重度患者(P<0.05)。中度、重度、极重度患者的支气管右肺上叶亚尖段管壁WT、TDR均大于轻度患者(P<0.05),极重度患者的支气管右肺上叶亚尖段管壁WA大于重度患者(P<0.05)。肺疾病急性期组患者的支气管右肺上叶尖段管壁WT与FEV_(1)占预计值百分比呈负相关(P<0.05),支气管右肺上叶亚尖段管壁WT、WA、TDR与FEV_(1)占预计值百分比均呈负相关(P<0.05)。结论:老年COPD急性期小气道诊断中螺旋CT的临床应用价值高。

Objective:To explore the clinical application of spiral CT in the diagnosis of small airway in the acute stage of chronic obstructive pulmonary disease (COPD) in the elderly.Method:A total of 50 elderly patients with acute COPD in Jiujiang NO.1 People’s Hospital from February 2020 to February 2021 were selected retrospectively as the acute stage of lung disease group and 50 patients with normal cardiopulmonary function as the normal cardiopulmonary function group.Both groups were examined by spiral CT.The results of bronchial wall measurement in the two groups were statistically analyzed,and the results of bronchial wall measurement in patients with different disease severity in the acute stage of lung disease group were statistically analyzed,and the correlation between the results of bronchial wall measurement and lung function was analyzed.Result:The airway wall thickness (WT) of the apical segment of the upper lobe of the right bronchus in the acute stage of lung disease group was greater than that in the normal cardiopulmonary function group,and the airway wall thickness/airway outer diameter (TDR) was lower than that in the normal cardiopulmonary function group (P<0.05);in the acute stage of lung disease group,the WT and WA in the subapical segment of the upper lobe of the right lung of the bronchus were higher than those in the normal cardiopulmonary function group,and the TDR was lower than that in the normal cardiopulmonary function group (P<0.05).In the acute stage of lung disease group,the WT and WA of the apical segment of the upper lobe of the right bronchus in severe and very severe patients were higher than those in mild and moderate patients,and the TDR was higher than those in mild and moderate patients (P<0.05);the WT of the apical segment of the right upper lobe of the bronchus in patients with very severe disease was greater than that in patients with severe disease (P<0.05).The WT,TDR of the subapical wall of the upper lobe of the right bronchus in moderate,severe and very severe patients was greater than that in mild patients (P<0.05),and the WA of the subapical wall of the upper lobe of the right bronchus in very severe patients was greater than that in severe patients (P<0.05).There was a significant negative correlation between WT and FEV_(1) in the percentage of predicted value in the acute stage of lung disease group (P<0.05).There was a significant negative correlation between WT,WA,TDR and the percentage of FEV_(1) in the predicted value (P<0.05).Conclusion:Spiral CT has high clinical value in the diagnosis of small airway in the acute stage of COPD in the elderly.