吸烟者小气道的MDCT呼吸双相定量分析及与肺功能的相关性研究

发布时间：2018-10-23 17:16

【摘要】：目的定量分析吸烟人群在多排螺旋CT(MDCT)呼吸双相扫描下的气道径线,并探索其与肺功能的相关性。方法回顾性分析纳入58例吸烟者,经肺功能检查证实其中14例为COPD患者,另纳入39名不吸烟且肺功能正常的人群作为对照组,97名受试者均接受肺功能检查和MDCT呼吸双相扫描。测量所有受试者3~6级气道吸气末的管壁厚度(I-T)、管腔面积(I-LA),管壁面积占横截面积的百分比(I-%WA)及腔面积的呼吸气末比值(E/I-LA),及各参数与肺功能指标中第1秒用力呼气量(FEV_1)、FEV_1实测值与预计值的比值(FEV_1%)、FEV_1与用力肺活量的比值(FEV_1/FVC)、及一氧化碳/肺泡扩散量(DLCO/VA%)的相关性。结果三组人群气道径线中I-LA3~5,I-T6,I-%WA5,E/I-LA3~6以及肺功能参数中FEV_1、FEV_1/FVC、DLCO/VA%均存在明显统计学差异(P0.05)。吸烟COPD组I-T与DLCO/VA%、E/I-LA与FEV_1/FVC,I-%WA6与FEV_1/FVC均呈明显负相关性,且I-T与DLCO/VA%相关性随3~6级气道减小而增大;I-LA4与FEV_1/FVC呈正相关。吸烟非COPD组的FEV_1与I-LA4、I-%WA4及E/I-LA3,FEV_1%与I-%WA6、DLCO/VA%与I-LA6均呈明显负相关性,且FEV_1与E/I-LA4的相关性较E/I-LA3,I-LA4增大。不吸烟对照组的I-T与DLCO/VA%,I-%WA4与FEV_1,E/I-L4与FEV_1呈明显负相关性。结论 MDCT双气相扫描能有效评价吸烟者小气道改变,且较肺功能检查能更早的发现吸烟者小气道的异常。
[Abstract]:Objective to quantitatively analyze the airway diameters of smokers under multislice spiral CT (MDCT) breath biphasic scanning and to explore the correlation between airway diameter and lung function. Methods retrospective analysis was performed in 58 smokers, 14 of whom were confirmed to be COPD patients by pulmonary function test, and 39 non-smokers with normal pulmonary function were included as control group. 97 subjects underwent pulmonary function examination and MDCT breath biphasic scanning. The wall thickness (I-T), lumen area (I-LA), the percentage of wall area to cross sectional area (I-%WA) and the respiratory / gas end ratio (E/I-LA) of all subjects at the end of inspiratory period were measured, and the forced expiratory volume of 1 second in each parameter and pulmonary function index was measured. (FEV_1), the ratio of FEV_1 measured value to predicted value (FEV_1%), FEV_1 to forced vital capacity (FEV_1/FVC), and carbon monoxide / alveolar diffusivity (DLCO/VA%). Results there were significant differences in FEV_1,FEV_1/FVC,DLCO/VA% between the three groups (P 0.05), and there were significant differences between the three groups in the airway diameter (I-LA3P), I-T6 (I-T6) and WA5E / I-LA3O6, and in the lung function parameters (P0.05). There was a negative correlation between I-T and DLCO/VA%,E/I-LA, FEV_1/FVC,I-%WA6 and FEV_1/FVC in smoking COPD group, and the correlation between I-T and DLCO/VA% increased with the decrease of 3-grade 6 airway, and I-LA4 was positively correlated with FEV_1/FVC. There was a negative correlation between FEV_1 and I-LA4I-WA4 and E- / I-LA3FEV _ (1%) and I-WA6DLCO / VA% and I-LA6 in non-smoking COPD group, and the correlation between FEV_1 and E/I-LA4 was higher than that of E- / I-LA3I-LA4. There was a negative correlation between I-T and DLCO/VA%,I-%WA4, FEV_1,E/I-L4 and FEV_1 in non-smoking control group. Conclusion MDCT dual gas phase scanning can effectively evaluate the small airway changes in smokers and can detect the abnormality of small airway in smokers earlier than that of pulmonary function examination.
【作者单位】：上海第二军医大学附属长征医院;
【基金】：2015年度“上海市浦江人才计划”(D类)基金资助项目(编号:15PJD002) 国家自然科学基金资助项目(编号:81230030、81370035、81501470、81501618)
【分类号】：R563.9;R816.4

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