肺活量功能参数与支气管扩张患者影像学特征和疾病严重程度的相关性研究

Correlation between vital capacity function parameters and imaging characteristics and disease severity in patients with bronchiectasis

目的分析肺活量功能参数与支气管扩张患者影像学特征和疾病严重程度的相关性。方法选取2020年8月至2023年8月的支气管扩张患者219例,根据肺功能分为通气正常组60例、阻塞性通气障碍组117例和限制性通气障碍组42例,观察患者疾病严重程度、影像学和病原学表现,分析肺功能参数与影像学和疾病严重程度的相关性。结果阻塞性通气障碍组患者多为双肺受累,改良Reiff评分,培养阳性率,铜绿假单胞菌和多重耐药菌比例高于其余两组。阻塞性通气障碍组患者FEV_(1)、FEV_(1)%预测值和FEV_(1)/FVC低于其余两组,mMRC、FACED和BSI得分高于其余两组。改良Reiff评分与FEV_(1)%预测值(r=-0.473;P<0.001)、FVC%预测值(r=-0.556;P<0.001)和FEV_(1)/FVC%预测值(r=-0.478;P<0.001)呈负相关,BSI评分与FEV_(1)%预测值(r=-0.442;P<0.001)和FVC%预测值(r=-0.363,P<0.001)呈负相关。结论支气管扩张患者多数患有阻塞性通气障碍,此类患者多伴有更多的呼吸困难症状,疾病和影像学表现更为严重。肺功能损害越严重的患者影像学和疾病严重程度也越高。

Objective To analyze the correlation between vital capacity function parameters and imaging characteristics and disease severity in patients with bronchiectasis.Methods 219 patients with bronchiectasis from August 2020 to August 2023 were selected and divided into the normal ventilation group(n=60),the obstructive ventilation disorder group(n=117)and the restrictive ventilation disorder group(n=42)according to lung function.Their disease severity,imaging and pathogenic manifestations were observed,and the correlation between lung function parameters and imaging and disease severity was analyzed.Results Patients in the obstructive ventilation disorder group were mostly affected by both lungs.The modified Reiff score,positive culture rate,and proportion of Pseudomonas aeruginosa and multidrug-resistant bacteria were higher than the other two groups.The FEV_(1),FEV_(1)%predictive value and FEV_(1)/FVC of patients in obstructive ventilation disorder group were lower than the other two groups,and the scores of MMRC,face and BSI were higher than the other two groups.The modified Reiff score was negatively correlated with FEV_(1)%predictive value(r=-0.473;P<0.001),FVC%predictive value(r=-0.556;P<0.001)and FEV_(1)/FVC%predictive value(r=-0.478;P<0.001),and the BSI score was negatively correlated with FEV_(1)%predictive value(r=-0.442;P<0.001)and FVC%predictive value(r=-0.363,P<0.001).Conclusion Most patients with bronchiectasis suffer from obstructive ventilation disorder,which is accompanied by more dyspnea symptoms and more serious disease and imaging manifestations.The more severe the pulmonary function damage,the higher the imaging and disease severity.