气管支气管变异与慢性阻塞性肺疾病的相关性研究

The Correlation between Tracheobronchial Variation and Chronic Obstructive Pulmonary Disease

目的通过对临床上经PFT诊断为COPD的患者应用MSCT图像后处理方法收集气管支气管变异的特征及参数,以探讨气管支气管变异与COPD的相关性。方法回顾性收集1132例本院诊断为COPD的患者的影像资料,确定气管支气管变异及分型,测量变异侧及对侧LAA%、LA、WT、WA%,并进行相关性分析。结果1.一般资料及CT定量参数:4种气管支气管变异类型与年龄差异均无统计学意义(P均>0.05)。气管憩室的CT定量参数LAA%-950、LAA%-910与其他3种气管支气管变异之间差异有统计学意义(P均<0.05),其他3种气管支气管变异之间差异均无统计学意义(P均>0.05)。2.CT定量参数及支气管参数:气管性支气管、副心脏支气管、双肺上叶分段异常变异侧与对侧的CT定量参数LAA%-950、LAA%-910及支气管参数LA、WT、WA%之间差异均有统计学意义(P均<0.05)。气管憩室LAA%-950、LAA%-910左右肺之间差异无统计学意义(P均>0.05)。3.CT定量参数与支气管参数的相关性分析:气管性支气管、副心脏支气管、双肺上叶分段异常变异侧的LAA%-950、LAA%-910与WT、WA%均呈正相关,与LA呈负相关。结论气管支气管变异的变异侧较对侧的肺气肿程度、气道壁厚度更严重,且存在气管支气管变异的患者可能更易患COPD。

Objective In order to explore the correlation between tracheobronchial variation and COPD,MSCT image post-processing was used to collect the characteristics and parameters of tracheobronchial variation in clinically diagnosed patients with COPD by PFT.Methods Imaging data of 1132 patients clinically diagnosed as COPD were retrospectively collected.CT scanning data were used to determine tracheobronchial variation and classification,and to measure LAA%,LA,WT,and WA%of the variable side and the contralateral side.And the correlation analysis is carried out.Results 1.General data and CT quantitative parameters:there was no statistical significance between the four types of tracheobronchial variation and age(all P>0.05).CT quantitative parameters of tracheal diverticulum LAA%-950 and LAA%-910 were significantly different from the other three tracheobronchial variants(all P<0.05),while there was no significant difference among the other three tracheobronchial variants(all P>0.05).2.CT quantitative parameters and bronchial parameters:CT quantitative parameters LAA%-950 and LAA%-910 of tracheal bronchus,accessory cardiac bronchi and abnormal segments of the upper lobes of both lungs and bronchial parameters LA,WT,WA%of the variant side and the contralateral side were statistically significant(all P<0.05).There was no significant difference between the lungs around LAA%-950 and LAA%-910 in the tracheal diverticulum(P>0.05).3.Correlation analysis between CT quantitative parameters and bronchial parameters:The LAA%-950 and LAA%-910 of tracheal bronchus,accessory cardiac bronchi,and abnormal segments of the upper lobes of both lungs variant side were positively correlated with WT and WA%,and negatively correlated with LA.Conclusion The degree of emphysema and airway wall thickness were more serious on the variant side of tracheobronchial variation than on the contralateral side.And patients with tracheobronchial variations may be more susceptible to COPD.