CT Bhalla评分与COPD合并支气管扩张患者肺功能的相关性

Correlation between CT Bhalla Score and Pulmonary Function in COPD Patients with Bronchiectasis

【目的】探讨慢性阻塞性肺疾病(COPD)合并支气管扩张患者计算机断层扫描(CT)Bhalla评分与肺功能的相关性。【方法】回顾性分析2021年1月至2022年1月本院收治的100例COPD患者的临床资料,根据是否合并支气管扩张分为单纯COPD组(COPD组,n=65)和合并支气管扩张组(支扩组,n=35)。比较两组患者CT Bhalla评分、肺功能指标[第一秒用力呼出气容积/用力肺活量比值(FEV1/FVC)、最大呼气流速(PEF)、6 min步行距离(6MWT)]、白介素-6(IL-6)、白介素-33(IL-3)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平;采用受试者工作特征(ROC)曲线分析CT Bhalla评分、肺功能指标、IL-6、IL-33、CRP、TNF-α对COPD合并支气管扩张的预测价值;采用Spearman秩相关分析肺功能指标、IL-6、IL-33、CRP、TNF-α水平与CT Bhalla评分的相关性。【结果】支扩组CT Bhalla评分、IL-6、IL-33、CPR和TNF-α水平显著高于COPD组,6MWT、FEV1/FVC、PEF低于COPD组(P<0.05);ROC曲线分析证实:CT Bhalla评分、6MWT、FEV1/FVC、PEF、IL-6、IL-33、CRP、TNF-α均可用于COPD合并支气管扩张的预测,曲线下面积分别为0.967、0.906、0.718、0.783、0.582、0.825、0.738、0.745;CT Bhalla评分与6MWT、FEV1/FVC、PEF呈负相关(P<0.05),与IL-6、IL-33、CPR和TNF-α呈正相关(P<0.05)。【结论】CT Bhalla评分在COPD合并支气管扩张患者中显著升高,且与肺功能、IL-6、IL-33、CPR和TNF-α水平密切相关。

【Objective】To investigate the correlation between Bhalla score of computed tomography(CT)and pulmonary function in patients with chronic obstructive pulmonary disease(COPD)and Bronchiectasis.【Methods】The clinical data of 100 patients with COPD admitted to our hospital from January 2021 to January 2022 were retrospectively analyzed.According to whether Bronchiectasis was combined or not,they were divided into a simple COPD group(COPD group,n=65)and a combined Bronchiectasis group(bronchiectasis group,n=35).CT Bhalla scores,lung function indexes(FEV1/FVC,PEF,6MWT),interleukin-6(IL-6),interleukin-33(IL-3),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)levels were compared between the two groups;The predictive value of CT Bhalla score,pulmonary function index,IL-6,IL-33,CRP,TNF-αin COPD with Bronchiectasis was analyzed by receiver operating characteristic(ROC)curve;Spearman rank correlation analysis was used to investigate the correlation between lung function indicators,IL-6,IL-33,CRP,TNF-αlevels,and CT Bhalla score.【Results】The CT Bhalla score,IL-6,IL-33,CPR and TNF-αlevels in the Bronchiectasis group were significantly higher than those in the COPD group,while 6MWT,FEV1/FVC,PEF were lower than those in the COPD group(P<0.05);Receiver operating characteristic analysis confirmed that CT Bhalla score,6MWT,FEV1/FVC,PEF,IL-6,IL-33,CRP,TNF-αcan be used to predict COPD with Bronchiectasis,and the area under the curve was 0.967,0.906,0.718,0.783,0.582,0.825,0.738,0.745 respectively;The CT Bhalla score was negatively correlated with 6MWT,FEV1/FVC,and PEF(P<0.05),and positively correlated with IL-6,IL-33,CPR,and TNF-α(P<0.05).【Conclusion】CT Bhalla score is significantly increased in COPD patients with Bronchiectasis,and is closely related to lung function,IL-6,IL-33,CPR and TNF-αlevels.