CAJ | 학술논문

目的：通过测量各个肺叶的低密度区容积百分比(low attenuation are as volume percentage,LAA%),评估慢性阻塞性肺疾病(COPD)患者肺功能受损及其严重程度。方法选择80例受试者(COPD患者50例及健康者30例),所有受试者均为现吸烟者,并行肺功能检查及CT深吸气末的全肺扫描。CT后处理软件(Thoracic VCAR 软件)将自动计算出各个肺叶的低密度区的LAA%,从而定量评价肺气肿的严重程度。应用单变量线性回归分析研究 CT参数与肺功能[第1 s 用力呼气容积(FEV1)的实测值与预计值的比值(FEV1%)、FEV1与用力肺活量(FVC)的比值(FEV1/FVC)、一氧化碳的弥散量(DLCO)、残气量与肺总量的比值(RV/TLC)]参数间的相关性。应用协方差分析比较组间的 CT参数的不同。结果所有 CT参数均与 FEV1%预计值、FEV1/FVC明显相关；除右肺中叶LAA%、右肺下叶LAA%与DLCO%预计值、RV/TLC之间没有相关性外,其余CT参数均与DLCO%预计值、RV/TLC明显相关；FEV1%预计值、DLCO%预计值、RV/TLC 均与左肺上叶 LAA%相关性最高,右肺下叶 LAA%与FEV1/FVC(R2=0.44,P=0.000)相关性最高。GOLD1与对照组间比较仅右肺 LAA%、右肺上叶 LAA%、总 LAA%之间有统计学差异。结论双肺及各个肺叶低密度区 LAA%可反映COPD患者肺功能受损情况。
목적：통과측량각개폐협적저밀도구용적백분비(low attenuation are as volume percentage,LAA%),평고만성조새성폐질병(COPD)환자폐공능수손급기엄중정도。방법선택80례수시자(COPD환자50례급건강자30례),소유수시자균위현흡연자,병행폐공능검사급CT심흡기말적전폐소묘。CT후처리연건(Thoracic VCAR 연건)장자동계산출각개폐협적저밀도구적LAA%,종이정량평개폐기종적엄중정도。응용단변량선성회귀분석연구 CT삼수여폐공능[제1 s 용력호기용적(FEV1)적실측치여예계치적비치(FEV1%)、FEV1여용력폐활량(FVC)적비치(FEV1/FVC)、일양화탄적미산량(DLCO)、잔기량여폐총량적비치(RV/TLC)]삼수간적상관성。응용협방차분석비교조간적 CT삼수적불동。결과소유 CT삼수균여 FEV1%예계치、FEV1/FVC명현상관；제우폐중협LAA%、우폐하협LAA%여DLCO%예계치、RV/TLC지간몰유상관성외,기여CT삼수균여DLCO%예계치、RV/TLC명현상관；FEV1%예계치、DLCO%예계치、RV/TLC 균여좌폐상협 LAA%상관성최고,우폐하협 LAA%여FEV1/FVC(R2=0.44,P=0.000)상관성최고。GOLD1여대조조간비교부우폐 LAA%、우폐상협 LAA%、총 LAA%지간유통계학차이。결론쌍폐급각개폐협저밀도구 LAA%가반영COPD환자폐공능수손정황。
Objective To determine the capability of quantitative low attenuation areas volume percentage(LAA%)in individual lobes to assess pulmonary function loss and disease severity in pulmonary COPD patients.Methods A total of 80 subjects (50 COPD patients;30 normal smokers),who all were smokers,underwent pulmonary function tests(PFTs)and Chest CT examination at full inspiration.For the quantitative assessment,percentage of low attenuation areas were automatically calculated for each lobe by the post processing software(Thoracic VCAR).To study the correlation between these CT parameters and lung function(FEV1% pre-dicted,FEV1/FVC,DLCO%predicted,RV/TLC),univariate linear regression analysis was performed.CT measurements were compared between the five groups with analysis of covariance(ANCOVA).Results FEV1 and FEV1/FVC had significant correla-tions with all of these CT parameters.DLCO、RV/TLC had significant correlations with these parameters,aside from the LAA% of right middle lobe and right inferior lobe.The LAA% in left upper lobe have the highest correlation with FEV1、DLCO、RV/TLC. However,FEV1/FVC have the highest correlation with the LAA% of right lower lobe.The LAA% of Right lung,right upper lobe,and whole lung were significantly different between the non-COPD group and GOLD1 group.Conclusion Whole lung and every lung lobe low attenuation areas volume percentage were reflected the lung function impairment in COPD patients.