慢阻肺患者肺功能与HRCT支气管壁厚度的相关性

黄倩; 李梅华; 汤晓静; 马葳; 杨艳霞; 郑勤玲; 和瑾

doi:10.12259/j.issn.2095-610X.S20220224

慢阻肺患者肺功能与HRCT支气管壁厚度的相关性

doi: 10.12259/j.issn.2095-610X.S20220224

1.
昆明市第一人民医院呼吸与危重症医学科，云南昆明　650011
2.
昆明市第一人民医院CT室，云南昆明　650011

基金项目: 昆明市卫生健康委员会科研基金资助项目（2019-03-02-003）

详细信息

作者简介:
黄倩（1994～），女，湖北咸宁人，在读硕士研究生，主要从事呼吸与危重症科临床工作

通讯作者:
李梅华，E-mail：524396521@qq.com

中图分类号: R563.9
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出版历程
- 收稿日期: 2021-12-19
- 网络出版日期: 2022-02-24
- 刊出日期: 2022-03-04

Correlation of Lung Function and HRCT Bronchial Wall Thickness in Patients with Chronic Obstructive Pulmonary Disease

1.
Dept. of Respiratory and Critical Care Medicine，The First People’s Hospital of Kunming，Kunming Yunnan 650011
2.
Dept. of CT Division，The First People’s Hospital of Kunming，Kunming Yunnan 650011，China

摘要

摘要: 目的研究慢性阻塞性肺疾病（chronic obstructive pulmonary disease， COPD）患者肺功能指标与高分辨率计算机断层扫描（high resolution computed tomography，HRCT）下测量的支气管壁厚度的相关性。方法将80例慢阻肺患者根据新版的 COPD 全球倡议分级分为4组，同时选取50个同期于该院体检的正常人群作为对照，对所有受试者行胸部HRCT扫描，测量双侧肺尖支气管开口处的支气管壁厚度，并与肺功能行相关性研究。结果 COPD患者较正常人群支气管壁厚度明显增加，两者差异有统计学意义（P < 0.05）。从轻度组到极重度组，双侧支气管壁厚度逐渐增加，FEV1、FVC、FEV1/FVC逐渐降低，差异均有统计学意义（P < 0.05）。相关性分析：双侧支气管壁厚度与肺功能各指标均呈明显负相关（P < 0.05）。结论 HRCT可用于测定支气管壁厚度，评估COPD患者支气管壁重构程度。慢阻肺患者随着疾病分级程度的加深，支气管壁厚度逐渐增加。肺功能指标与支气管壁厚度之间具有明显的相关性，即支气管壁越增厚，肺功能各指标越下降，肺功能越差，COPD患者HRCT测定支气管壁厚度对病情严重程度的评估具有临床意义。
- 慢性阻塞性肺疾病 /
- 高分辨率计算机断层扫描 /
- 肺功能 /
- 支气管壁厚度
Abstract: Objective To investigate the correlation of pulmonary function indexes and bronchial wall thickness measured as computed with high resolution computed tomography in patients with chronic obstructive pulmonary diseases. Methods Eighty COPD patients were assigned to four groups based on the new COPD Global Initiative Classification, meanwhile, fifty normal people with physical examination in the hospital were selected as controls simultaneously. All subjects underwent chest HRCT scanning to measure the bronchial wall thickness at the bilateral apical bronchial opening, and the correlation between the bronchial wall thickness and lung function was studied. Results Bronbronchial wall thickness was significantly increased in COPD patients compared with normal population, and the difference was statistically significant （P < 0.05）. From the mild group to the very severe group, the bilateral bronchial wall thickness gradually increased, FEV1, FVC, FEV1/FVC gradually decreased, with statistically significant differences （P < 0.05）. Correlation analysis: bilateral bronchial wall thickness was significantly inversely associated with each index of lung function （P < 0.05）. Conclusions HRCT can be used to measure bronchial wall thickness and evaluate the degree of bronchial wall remodeling in COPD patients. With the deepening of the disease grade, the thickness of the bronchial wall of COPD patients gradually increased. There is a significant correlation between lung function indexes and bronchial wall thickness, that is, the thickening of bronchial wall, the decline of lung function indexes and the deterioration of lung function. HRCT measurement of bronchial wall thickness in COPD patients has clinical significance for the evaluation of the severity of the disease.
- Chronic obstructive pulmonary disease /
- High resolution computed tomography /
- Lung function /
- Bronchial wall thickness.

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表 1 慢阻肺组与正常组之间的支气管壁厚度比较（$\bar x \pm s $）

Table 1. Comparison of bronchi wall thickness between the COPD group and the normal population （$\bar x \pm s $）

组别	例数	左侧支气管壁厚度	右侧支气管壁厚度
COPD组	80	1.47 ± 0.20	1.51 ± 0.26
正常组	50	1.09 ± 0.11	1.09 ± 0.12
T值		13.54	10.80
P值		< 0.001^*	< 0.001^*
^*P < 0.05。

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表 2 各组受试者指标比较（$\bar x \pm s $）

Table 2. Comparison of subjects indicators in each group （$\bar x \pm s $）

组别	n	FEV1	FVC	FEV1/FVC	右侧	左侧
轻度组	12	1.95 ± 0.25	2.93 ± 0.38	66.19 ± 2.88	1.08 ± 0.09	1.20 ± 0.13
中度组	22	1.26 ± 0.15	2.23 ± 0.21	56.71 ± 5.14	1.32 ± 0.13	1.35 ± 0.14
重度组	20	0.84 ± 0.13	1.64 ± 0.35	51.03 ± 4.55	1.60 ± 0.15	1.55 ± 0.13
极重度组	26	0.44 ± 0.17	1.06 ± 0.29	41.5 ± 4.99	1.74 ± 0.17	1.65 ± 0.14
F		271.91	196.08	134.12	33.46	61.85
p		< 0.001^*	< 0.001^*	< 0.001^*	< 0.001^*	< 0.001^*
^*P < 0.05。

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表 3 慢阻肺患者支气管壁厚度与肺功能的相关性

Table 3. Correlation of bronchial wall thickness and lung function in patients with COPD

组别	FEV1		FVC		FEV1/FVC
组别	r	p	r	p	r	p
左侧支气管壁厚度	−0.74	< 0.001^*	−0.70	< 0.001^*	−0.73	< 0.001^*
右侧支气管壁厚度	−0.80	< 0.001^*	−0.78	< 0.001^*	−0.72	< 0.001^*
^*P < 0.05。

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参考文献(12)

[1]	Vogelmeier C F,Criner G J,Martinez F J,et al. Global strategy for the diagnosis,management and prevention of chronic obstructive lung disease 2017 report:GOLD executive summary[J]. Respirology,2017,22:575-601. doi: 10.1111/resp.13012
[2]	Singh D,Agusti A,Anzueto A,et al. Global Strategy for the Diagnosis,Management,and Prevention of Chronic Obstructive Lung Disease:The GOLD Science Committee Report[J]. Eur Respir J,2019,53:1900164. doi: 10.1183/13993003.00164-2019
[3]	Murray C J,Lopez A D. Measuring the global burden of disease[J]. N Engl J Med,2013,369:448-457. doi: 10.1056/NEJMra1201534
[4]	GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases,1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet Respir Med,2020,8(6):585-596. doi: 10.1016/S2213-2600(20)30105-3
[5]	Blasi F,Neri L,Centanni S,et al. Clinical characterization and treatment patterns for the frequent exacerbator phenotype in chronic obstructive pulmonary disease with severe or very severe airflow limitation[J]. COPD,2017,14(1):15-22. doi: 10.1080/15412555.2016.1232380
[6]	Rossi Andrea,Butorac-Petanjek Bojana,Chilosi Marco,et al. Chronic obstructive pulmonary disease with mild airflow limitation:current knowledge and proposal for future research - a consensus document from six scientific societies.[J]. Int J Chron Obstruct Pulmon Dis,2017,12:2593-2610. doi: 10.2147/COPD.S132236
[7]	Washko G R,Coxson H O,O'Donnell D E,et al. CT imaging of chronic obstructive pulmonary disease:insights,disappointments,and promise[J]. Lancet Respir Med,2017,5(11):903-908. doi: 10.1016/S2213-2600(17)30345-4
[8]	Petty T L,Weinmann G G. Building a national strategy for the prevention and management of and research in chronic obstructive pulmonary disease. National Heart,Lung,and Blood Institute Workshop Summary. Bethesda,Maryland,August 2931,1995[J]. JAMA,1997,277(3):246-253. doi: 10.1001/jama.1997.03540270072029
[9]	Lynch D A,Austin J H,Hogg J C,et al. CT-de fifinable subtypes of chronic obstructive pulmonary disease:a statement of the Fleischner Society[J]. Radiology,2015,277:192-205. doi: 10.1148/radiol.2015141579
[10]	Hogg J C,Macklem P T,Thurlbeck W M. Site and nature of airway obstruction in chronic obstructive lung disease[J]. N Engl J Med,1968,278:1355-1360.
[11]	Hogg J C,Chu F,Utokaparch S,et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease[J]. N Engl J Med,2004,350:2645-2653. doi: 10.1056/NEJMoa032158
[12]	Kumar I,Verma A,Jain A,et al. Performance of quantitative CT parameters in assessment of disease severity in COPD:A prospective study[J]. Indian J Radiol Imag,2018,28(1):99-106. doi: 10.4103/ijri.IJRI_296_17

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