气道内超声测量慢性阻塞性肺疾病患者气道径线与肺功能的关系
发布时间：2018-10-11 12:23
【摘要】：【目的】应用气道内超声(EBUS)检测慢性阻塞性肺疾病(COPD)患者的气道重塑,并探讨EBUS测量的COPD患者气道径线与患者肺功能之间的关系。【方法】40例受试者分为COPD组(20例)和对照组(20例)两组,均进行EBUS及肺功能检查。EBUS检查受试者的左主支气管、左上叶支气管、右中叶支气管和右下叶后基底段支气管(B10),并测量其管壁总厚度(T)、黏膜层厚度(TL1)、黏膜下层厚度(TL2)、外膜层总厚度(TL3~L5)、管腔面积(Ai)和管壁面积(WA)。【结果】左主支气管:COPD组的T、TL1、TL2、WA大于对照组,P均0.05,两组TL3~L5、Ai相近;左上叶支气管:COPD组的T、TL1、WA大于对照组,P均0.05,两组TL2、TL3~L5、Ai相近;右中叶支气管和右B10:COPD组的T、TL1、TL2、WA大于对照组,Ai小于对照组,P均0.05,两组TL3~L5相近。相关性分析:左主支气管的径线与肺功能无显著相关关系。叶支气管的黏膜层和黏膜下层的增厚与COPD的气流受限相关,结果如下:COPD患者左上叶支气管TL1与FEV1、FVC(r=-0.517~-0.448)呈负相关。右中叶支气管的TL1与FEV1/FVC呈负相关(r=-0.533);TL2与FEV1、FVC(r=-0.590~-0.507)呈负相关。相对于叶支气管,右B10黏膜层和黏膜下层厚度与气流受限的相关性更强,管壁总厚度和面积与气流受限的相关性不及黏膜(L1)和黏膜下层(L2)强,结果如下:右B10的T与FEV1、FEV1%、FVC和FVC%(r=-0.519~-0.504)呈负相关;TL1与FEV1、FEV1%、FVC、FVC%和FEV1/FVC(r=-0.902~-0.566)呈负相关;TL2与FEV1、FEV1%和FVC%呈负相关(r=-0.597~-0.472);Ai与FEV1(r=0.475)、FEV1%、FVC和FVC%呈正相关(r=0.457~0.527);WA与FEV1%和FVC%(r=-0.502~-0.470)呈负相关。【结论】COPD患者1~4级支气管的气道壁明显增厚,尤其是黏膜层和黏膜下层,管腔有狭窄趋势,这些气道的径线与气流受限存在一定的相关性,并且这种相关关系在分级较高的支气管中较明显;EBUS相对无创,并且可以精确的反映气道壁各层厚度的实际变化,是理想的气道形态学检测方法,并有希望成为COPD气道重塑的诊断手段。
[Abstract]:[objective] to detect airway remodeling in patients with chronic obstructive pulmonary disease (COPD) by intraairway ultrasound (EBUS). [methods] 40 subjects were divided into two groups: COPD group (n = 20) and control group (n = 20). Both EBUS and pulmonary function were examined. EBUS was used to examine the left main bronchus. The left upper lobe bronchus, The thickness of (T), mucosal layer (TL1), submucosal thickness (TL2), total adventitia thickness (TL3~L5), lumen area (Ai) and left main bronchus (WA).) were measured in the right middle lobe bronchus and the right inferior posterior basal segment bronchus (B10). [results] left main bronchus: COPD group The TL3~L5,Ai of TL1 / TL2OWA was higher than that of the control group (P < 0.05). The TL3~L5,Ai of the two groups was similar. Left superior lobar bronchus: TL1WA in COPD group was higher than that in control group (P 0.05), TL2,TL3~L5,Ai was similar in two groups, TL1TL1 TL2WA in right middle lobe bronchus and right B10:COPD group was higher than that in control group, Ai was lower than that in control group (P 0.05), TL3~L5 in both groups was similar. Correlation analysis: there was no significant correlation between the diameter of left main bronchus and pulmonary function. The thickening of the mucous layer and submucous layer of lobar bronchus was related to the airflow limitation of COPD. The results were as follows: the TL1 of left upper lobe bronchus was negatively correlated with FEV1,FVC (r-0.517 ~ 0.448) in patients with COPD. There was a negative correlation between TL1 and FEV1/FVC in the right middle lobe bronchus (r-0.533), and a negative correlation between TL2 and FEV1,FVC (r-0.590 ~ 0.507). Compared with lobar bronchus, the thickness of right B10 mucosal layer and submucosal layer was more correlated with airflow limitation than that of mucosal (L1) and submucosal submucosa (L2), and the correlation between total thickness and area of wall was less than that of mucosal (L1) and submucosal (L2). 缁撴灉濡備笅:鍙矪10鐨凾涓嶧EV1,FEV1%,FVC鍜孎VC%(r=-0.519~-0.504)鍛堣礋鐩稿叧;TL1涓嶧EV1,FEV1%,FVC,FVC%鍜孎EV1/FVC(r=-0.902~-0.566)鍛堣礋鐩稿叧;TL2涓嶧EV1,FEV1%鍜孎VC%鍛堣礋鐩稿叧(r=-0.597~-0.472);Ai涓嶧EV1(r=0.475),FEV1%,FVC鍜孎VC%鍛堟鐩稿叧(r=0.457~0.527);WA涓嶧EV1%鍜孎VC%(r=-0.502~-0.470)鍛堣礋鐩稿叧.銆愮粨璁恒，
本文编号：2264177
[Abstract]:[objective] to detect airway remodeling in patients with chronic obstructive pulmonary disease (COPD) by intraairway ultrasound (EBUS). [methods] 40 subjects were divided into two groups: COPD group (n = 20) and control group (n = 20). Both EBUS and pulmonary function were examined. EBUS was used to examine the left main bronchus. The left upper lobe bronchus, The thickness of (T), mucosal layer (TL1), submucosal thickness (TL2), total adventitia thickness (TL3~L5), lumen area (Ai) and left main bronchus (WA).) were measured in the right middle lobe bronchus and the right inferior posterior basal segment bronchus (B10). [results] left main bronchus: COPD group The TL3~L5,Ai of TL1 / TL2OWA was higher than that of the control group (P < 0.05). The TL3~L5,Ai of the two groups was similar. Left superior lobar bronchus: TL1WA in COPD group was higher than that in control group (P 0.05), TL2,TL3~L5,Ai was similar in two groups, TL1TL1 TL2WA in right middle lobe bronchus and right B10:COPD group was higher than that in control group, Ai was lower than that in control group (P 0.05), TL3~L5 in both groups was similar. Correlation analysis: there was no significant correlation between the diameter of left main bronchus and pulmonary function. The thickening of the mucous layer and submucous layer of lobar bronchus was related to the airflow limitation of COPD. The results were as follows: the TL1 of left upper lobe bronchus was negatively correlated with FEV1,FVC (r-0.517 ~ 0.448) in patients with COPD. There was a negative correlation between TL1 and FEV1/FVC in the right middle lobe bronchus (r-0.533), and a negative correlation between TL2 and FEV1,FVC (r-0.590 ~ 0.507). Compared with lobar bronchus, the thickness of right B10 mucosal layer and submucosal layer was more correlated with airflow limitation than that of mucosal (L1) and submucosal submucosa (L2), and the correlation between total thickness and area of wall was less than that of mucosal (L1) and submucosal (L2). 缁撴灉濡備笅:鍙矪10鐨凾涓嶧EV1,FEV1%,FVC鍜孎VC%(r=-0.519~-0.504)鍛堣礋鐩稿叧;TL1涓嶧EV1,FEV1%,FVC,FVC%鍜孎EV1/FVC(r=-0.902~-0.566)鍛堣礋鐩稿叧;TL2涓嶧EV1,FEV1%鍜孎VC%鍛堣礋鐩稿叧(r=-0.597~-0.472);Ai涓嶧EV1(r=0.475),FEV1%,FVC鍜孎VC%鍛堟鐩稿叧(r=0.457~0.527);WA涓嶧EV1%鍜孎VC%(r=-0.502~-0.470)鍛堣礋鐩稿叧.銆愮粨璁恒，
本文编号：2264177
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