COPD患者双相CT参数与肺功能指标的相关性研究

发布时间：2018-04-13 09:00

本文选题：肺疾病 + 慢性阻塞性　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:应用多层螺旋CT(MSCT)对收集的COPD患者及正常志愿者分别于深吸气末和深呼气末行双相扫描,通过测量小气道相关参数,分析COPD组与正常对照组小气道各参数的差异及COPD组小气道参数与肺功能指标的相关性,探讨MSCT双相扫描测量小气道参数对诊断及评价COPD的可行性及临床应用价值。方法:收集76例COPD患者及14例健康志愿者,采用128层螺旋CT分别于深吸气末和深呼气末对受试者行全肺扫描;在不超过一周内行肺功能检查;应用后处理软件测量每位患者左肺上叶尖后段、右肺上叶尖段、左肺下叶后基底段、右肺下叶后基底段小气道壁厚度(WT)、管腔面积(AI)、断面总面积(AT),并计算壁面积(WA)、壁面积百分比(WA%);用两独立样本t检验分别比较吸气相、呼气相正常对照组与COPD组小气道WT、AI、WA、WA%之间的差异,并采用Pearson相关分析法分析COPD组吸气相与呼气相小气道各参数和肺功能指标的相关性。结果:(1)呼气相、吸气相正常对照组与COPD组小气道WT、AI、WA、WA%均有统计学差异(P0.05)。(2)COPD组吸气相和呼气相小气道WT、AI、WA、WA%与肺功能FEV1、FEV1/FVC%均有相关性;且WT、WA、WA%与肺功能FEV1及FEV1/FVC%均呈负相关,AI与肺功能FEV1及FEV1/FVC%呈正相关。(3)COPD组小气道WT、AI、WA、WA%与肺功能FEV1、FEV1/FVC%相关系数呼气相要高于吸气相。(4)COPD患者呼气相下小气道WT、AI、WA、WA%与肺功能指标FEV1、FEV1/FVC%均有相关性,且下肺的相关系数高于双肺上叶的相关系数。结论:COPD患者小气道管壁壁厚度较正常健康者增厚,而管腔面积却逐渐减小;采用MSCT呼吸双相扫描对于评价COPD患者气流受限是可行的,气道壁厚、管腔面积、壁面积及壁面积百分比可以作为反映COPD患者气道改变的指标;双相扫描能更全面及动态地反应COPD患者小气道病变的情况;且双肺下叶气道壁增厚对于肺功能的影响较肺上叶大。
[Abstract]:Objective: to measure the parameters of small airway in COPD patients and normal volunteers by using multislice spiral CT scanning at deep inspiratory end and deep expiratory end, respectively.To analyze the difference of small airway parameters between COPD group and normal control group and the correlation between small airway parameters and pulmonary function index in COPD group, to explore the feasibility and clinical application value of MSCT biphasic scanning measurement of small airway parameters in diagnosis and evaluation of COPD.Methods: a total of 76 patients with COPD and 14 healthy volunteers were examined with 128-slice spiral CT at the end of deep inspiratory and deep expiratory, respectively.Postprocessing software was used to measure the posterior segment of the left superior lobe, the apical segment of the right lung, the posterior basal segment of the left lower lobe of the left lung, and the posterior basal segment of the left lower lobe of the left lung.The thickness of the small airway wall and the lumen area of the posterior basal segment of the right lower lobe of the right lung are WTT, and the lumen area is greater than that of the others. The total area of the section is calculated and the area of the wall is calculated, and the percentage of the wall area is calculated, and the inspiratory phase is compared with the t test of two independent samples.The difference of small airway WT-AIWA-WA% between normal expiratory control group and COPD group was analyzed by Pearson correlation analysis. The correlation between inspiratory and expiratory small airway parameters and pulmonary function index in COPD group was analyzed by Pearson correlation analysis.Results there was a significant difference in expiratory phase, inspiratory phase and COPD group. There was a significant correlation between inspiratory phase and expiratory small airway WTA / FEV1 / FVC%.The correlation coefficient of lower lung was higher than that of upper lobe of both lungs.Conclusion the wall thickness of small airway wall is thicker than that of normal controls, but the lumen area decreases gradually in the patients with COPD, and it is feasible to evaluate the airflow limitation by using MSCT breath biphasic scanning, the thickness of the airway wall and the area of the lumen of the patients with COPD, and the thickness of the airway wall and the area of the lumen.The wall area and the percentage of wall area can be used as indicators to reflect the airway changes in COPD patients; biphasic scanning can more comprehensively and dynamically reflect the condition of small airway lesions in patients with COPD; and the thickening of the wall of the inferior lobe of both lungs has a greater effect on the pulmonary function than that on the upper lobe of the lung.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9;R816.41

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