CAJ | 학술논문

目的：探讨慢性阻塞性肺疾病（ COPD）患者中呼吸双相高分辨率CT肺定量指标与肺功能检查各项指标的相关性。方法将54例COPD患者按照病变严重程度分为轻度组5例、中度组21例、重度组19例及极重度组9例，四组均行呼吸双相全肺高分辨率CT检查，检测深吸气末、深呼气末肺密度、呼吸双相肺密度差及肺容积，分析肺密度与肺容积和肺功能各指标的相关性。结果四组患者深吸气末与深呼气末肺密度差异均有统计学意义（t＝13．67、9．89，均P＜0．05）；四组第1秒用力呼气量（FEV1）、用力肺活量（FVC）及FEV1／FVC比值差异均有统计学意义（t＝1．15、0．89、7．89、13．76、16．67，均P＜0．05）；随COPD严重程度的增加，深吸气末与深呼气末肺容积均相应增加，但四组间差异均无统计学意义（ t＝15．46、13．28、11．47，均P＞0．05）；胸部重建后深吸气末及深呼气末肺容积与FEV1、FVC、FEV1／FVC有明显相关性（ r＝－0．071、－0．083，r＝－0．713、－0．542，r＝－0．622、0．639，均P＜0．05）；深呼气末肺容积与残气量占最大肺总量百分比预计值间有明显相关性（r＝0．622，P＜0．05）；深吸气相肺密度与FEV1／FVC、残气量值有明显相关性（r＝0．539，P＜0．05）。结论 COPD患者的呼吸双相高分辨率螺旋CT的肺定量指标与肺功能检测指标间具有良好的相关性，可用于评价COPD严重程度。
목적：탐토만성조새성폐질병（ COPD）환자중호흡쌍상고분변솔CT폐정량지표여폐공능검사각항지표적상관성。방법장54례COPD환자안조병변엄중정도분위경도조5례、중도조21례、중도조19례급겁중도조9례，사조균행호흡쌍상전폐고분변솔CT검사，검측심흡기말、심호기말폐밀도、호흡쌍상폐밀도차급폐용적，분석폐밀도여폐용적화폐공능각지표적상관성。결과사조환자심흡기말여심호기말폐밀도차이균유통계학의의（t＝13．67、9．89，균P＜0．05）；사조제1초용력호기량（FEV1）、용력폐활량（FVC）급FEV1／FVC비치차이균유통계학의의（t＝1．15、0．89、7．89、13．76、16．67，균P＜0．05）；수COPD엄중정도적증가，심흡기말여심호기말폐용적균상응증가，단사조간차이균무통계학의의（ t＝15．46、13．28、11．47，균P＞0．05）；흉부중건후심흡기말급심호기말폐용적여FEV1、FVC、FEV1／FVC유명현상관성（ r＝－0．071、－0．083，r＝－0．713、－0．542，r＝－0．622、0．639，균P＜0．05）；심호기말폐용적여잔기량점최대폐총량백분비예계치간유명현상관성（r＝0．622，P＜0．05）；심흡기상폐밀도여FEV1／FVC、잔기량치유명현상관성（r＝0．539，P＜0．05）。결론 COPD환자적호흡쌍상고분변솔라선CT적폐정량지표여폐공능검측지표간구유량호적상관성，가용우평개COPD엄중정도。
Objective To study the relationship between pulmonary quantitative indicators on 64-slice spiral CT and lung function,and the diagnosis value of breathing bipolar lung CT scan to emphysema.Methods 54 chronic obstructive pulmonary disease patients were divided into the mild group ( n =5 ) , moderate group ( n =21 ) , severe group(n=19) and gravely severe group(n=9).Four groups received breathing bipolar total lung high-resolution CT scan to test lung density at the end of deep inspiration and expiration,breathing bipolar lung density difference and lung volume,and the relationship between lung density/volume and lung function indicators were analyzed.Results There were significant differences in lung density at the end of deep inspiration and expiration(t=13.67,9.89,all P<0.05),the forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and FEV1/FVC among these fourgroups(t=1.15,0.89,7.89,13.76,16.67,all P<0.05).The lung volume at the end of inspiration and expiration increased with the severity of disease,while there were no significant differences among these four groups (t=15.46,13.28,11.47,all P>0.05).The lung volumes at the end of deep inspiration and expiration were obvi-ously correlated with FVC,FEV1 and FEV1/FVC(r=-0.071,-0.083,r=-0.713,-0.542,r=-0.622,0.639, all P<0.05) .The lung volume at the end of deep expiration was obviously correlated with the expected ratio of resid-ual volume to maximum total lung capacity(r=0.622,P<0.05).The deep aspiratory phase lung density was closely correlated with FEV1/FVC and residual volume(r=0.539,P<0.05).Conclusion Pulmonary quantitative indica-tors on 64-slice spiral CT and pulmonary function has good correlation,which can be used to evaluate the severity of emphysema in patients with chronic obstructive pulmonary disease.