CAJ | 학술논문

目的：探讨HRCT对COPD进行表现型分型的价值。方法对127名处于稳定期的COPD患者(FEV1<80%)使用HRCT进行胸部扫描，分析其肺气肿和支气管管壁增厚的程度，以此将患者分为3个表型：存在轻微肺气肿或无肺气肿，伴或不伴支气管管壁增厚(A表型)；存在肺气肿但不伴有支气管管壁增厚(E表型)；有较重的肺气肿并伴有较重的支气管管壁增厚(M表型)，分析各表型相应的临床表现和肺功能特征。结果 A表型中不吸烟的人数、活动及静止时均出现哮喘的发病率、体质指数及CO弥散率最高，肺功能指标显示肺通气障碍较轻；M表型则有大量咳痰、排痰性咳嗽及哮喘，可逆性气流受限较E表型严重。结论以HRCT对COPD进行形态学表现型分型，可以显示不同表型的多个临床特点及肺功能特征。
목적：탐토HRCT대COPD진행표현형분형적개치。방법대127명처우은정기적COPD환자(FEV1<80%)사용HRCT진행흉부소묘，분석기폐기종화지기관관벽증후적정도，이차장환자분위3개표형：존재경미폐기종혹무폐기종，반혹불반지기관관벽증후(A표형)；존재폐기종단불반유지기관관벽증후(E표형)；유교중적폐기종병반유교중적지기관관벽증후(M표형)，분석각표형상응적림상표현화폐공능특정。결과 A표형중불흡연적인수、활동급정지시균출현효천적발병솔、체질지수급CO미산솔최고，폐공능지표현시폐통기장애교경；M표형칙유대량해담、배담성해수급효천，가역성기류수한교E표형엄중。결론이HRCT대COPD진행형태학표현형분형，가이현시불동표형적다개림상특점급폐공능특정。
Objective To explore the value of HRCT phenotypes of chronic obstructive pulmonary disease. Methods A total of 127 patients with stable COPD (FEV1<80%) were examined by chest High-resolution CT. Emphysematous changes and bronchial wall thickening (BWT) were evaluated visually, and COPD patients were classified into three phenotypes:absence of emphysema, with little emphysema with or without BWT (A phenotype), emphysema without BWT (E phenotype) and emphysema with BWT phenotype (M phenotype). The clinical characteristics were compared among the three phenotypes. Results The A phenotype showed a higher prevalence of those who had never smoked and patients with wheezing both on exertion and at rest, higher values of BMI and diffusing capacity for carbon mononide and milder lung hyperinflation. The M phenotype showed a higher prevalence of patients complaining of a large amount of sputum, productive cough and wheezing, and greater reversibility of airflow limitation responsive compared with the E phenotype. Conclusion These findings suggest that the morphological phenotypes of COPD show several clinical characteristics and different lung function characteristic.