CAJ | 학술논문

目的探讨不同高分辨CT分型的慢性阻塞性肺疾病（COPD）与肺功能以及肺动脉高压（PH）的关系。方法入选COPD稳定期患者98例，进行胸部高分辨CT检查和影像学表型分型，同时进行肺功能测定、心脏超声多普勒检查，分析比较各表型COPD患者的肺功能特点和肺动脉压。结果根据胸部高分辨CT的表现将COPD分为3种类型：（1）A型（32例）无或轻度肺气肿，合并或不合并支气管管壁增厚；（2）E型（34例）有肺气肿，不合并支气管管壁增厚；（3）M型（32例）有肺气肿和支气管管壁增厚。吸入支气管舒张剂后，第1秒用力肺活量（FEV1）改善值在A型和M型COPD患者明显高于E型（P＜0.01）；而深吸气量（IC）改善值在E型和M型COPD患者明显高于A型（均P＜0.01）；A型患者的FEV1/FVC和FEV1%预计值明显高于E型和M型（P＜0.01）；M型患者的平均肺动脉收缩压为明显高于E型和A型（P＜0.01）；M型PH发生率明显高于A型和E型（P＜0.05）。结论3种高分辨CT分型的COPD有不同的肺功能特点，其中M型COPD患者的PH发生率高于其他两型。
목적탐토불동고분변CT분형적만성조새성폐질병（COPD）여폐공능이급폐동맥고압（PH）적관계。방법입선COPD은정기환자98례，진행흉부고분변CT검사화영상학표형분형，동시진행폐공능측정、심장초성다보륵검사，분석비교각표형COPD환자적폐공능특점화폐동맥압。결과근거흉부고분변CT적표현장COPD분위3충류형：（1）A형（32례）무혹경도폐기종，합병혹불합병지기관관벽증후；（2）E형（34례）유폐기종，불합병지기관관벽증후；（3）M형（32례）유폐기종화지기관관벽증후。흡입지기관서장제후，제1초용력폐활량（FEV1）개선치재A형화M형COPD환자명현고우E형（P＜0.01）；이심흡기량（IC）개선치재E형화M형COPD환자명현고우A형（균P＜0.01）；A형환자적FEV1/FVC화FEV1%예계치명현고우E형화M형（P＜0.01）；M형환자적평균폐동맥수축압위명현고우E형화A형（P＜0.01）；M형PH발생솔명현고우A형화E형（P＜0.05）。결론3충고분변CT분형적COPD유불동적폐공능특점，기중M형COPD환자적PH발생솔고우기타량형。
Objective To evaluate the lung function and the pulmonary hypertension in chronic obstructive pulmonary disease (COPD) phenotypes based on high- resolution CT (HRCT). Methods Ninety- eight stable COPD patients were enrol ed in this study. The chest HRCT, lung function, color Doppler echocardiography examinations were performed. The patients were classified into different phenotypes according to the HRCT findings. The characteristics of lung function and the pulmonary hy-pertension were compared among different phenotypes. Results The patients were classified into three phenotypes:phenotype A (n=32) presenting no emphysema with or without bronchial wal chickening;phenotype E (n=34) presenting emphysema but no bronchial wal chickening;phenotype M (n=32) presenting both emphysema and bronchial wal chickening. The improvement of forced expiratory volume in one second (FEV1) after inhaled bronchodilator in phenotypes A and M was more marked than that in phenotype E(P<0.01);the improvement of inspiratory capacity (IC) in phenotypes E and M after inhaled bronchodilator was more marked than that in phenotype A(P<0.01). The FEV1/FVC and FEV1%in phenotype A were significantly higher than those in phe-notypes E and M(P<0.01). The rate of pulmonary hypertension in phenotype M was significantly higher than that in phenotypes E and A(P<0.05). Conclusion Various phenotypes of COPD classified based on HRCT findings present different characteristics in lung function and pulmonary hypertension.