CAJ | 학술논문

目的探讨慢性阻塞性肺病(慢阻肺)稳定期患者综合评估分组的影像表型.方法 2013年7月至2014年11月,在北京大学第三医院呼吸科门诊就诊的慢阻肺稳定期患者94例,其中男83例,女11例,平均年龄(65±11)岁.按慢阻肺2014综合评估分组方法分为4组,行CT低剂量扫描,软件分析肺气肿占全肺体积百分比(LAA％);右肺上叶尖段开口处支气管内径(LD)、管壁平均厚度(WT)、管壁厚度与外径比(TDR)、管壁面积、管壁面积占总横截面积百分比(WA％).用体表面积平方根√BSA)和体表面积(BSA)分别对气道径线、面积进行校正.结果 LAA％、WT/√BSA和WA/BSA:A组＜C组＜D组(均P＜0.01),B组＜C组＜D组(均P＜0.01),A、B组间差异无统计学意义;TDR、WA％:A、B组分别小于C、D组,A/B组、C/D组间差异无统计学意义;按症状轻重分组(CAT＜ 10和CAT≥10),除TDR,症状轻组＜症状重组(均P＜0.05);按急性加重风险分组(前1年加重频率＜2和≥2),除TDR与WA％,低风险组＜高风险组(均P＜0.05);所有指标均与FEV1％、RV/TLC以及D.CO存在较好的相关性;与慢阻肺评估测试评分(CAT)以及急性加重频率均存在较好的相关性.结论慢阻肺综合评估分组具有不同的CT影像表型,能够反映不同疾病程度病理改变.
목적 탐토만성조새성폐병(만조폐)은정기환자종합평고분조적영상표형.방법 2013년7월지2014년11월,재북경대학제삼의원호흡과문진취진적만조폐은정기환자94례,기중남83례,녀11례,평균년령(65±11)세.안만조폐2014종합평고분조방법분위4조,행CT저제량소묘,연건분석폐기종점전폐체적백분비(LAA％);우폐상협첨단개구처지기관내경(LD)、관벽평균후도(WT)、관벽후도여외경비(TDR)、관벽면적、관벽면적점총횡절면적백분비(WA％).용체표면적평방근√BSA)화체표면적(BSA)분별대기도경선、면적진행교정.결과 LAA％、WT/√BSA화WA/BSA:A조＜C조＜D조(균P＜0.01),B조＜C조＜D조(균P＜0.01),A、B조간차이무통계학의의;TDR、WA％:A、B조분별소우C、D조,A/B조、C/D조간차이무통계학의의;안증상경중분조(CAT＜ 10화CAT≥10),제TDR,증상경조＜증상중조(균P＜0.05);안급성가중풍험분조(전1년가중빈솔＜2화≥2),제TDR여WA％,저풍험조＜고풍험조(균P＜0.05);소유지표균여FEV1％、RV/TLC이급D.CO존재교호적상관성;여만조폐평고측시평분(CAT)이급급성가중빈솔균존재교호적상관성.결론 만조폐종합평고분조구유불동적CT영상표형,능구반영불동질병정도병리개변.
Objective To explore the HRCT phenotype of the combined COPD assessment staging system.Methods Ninety-four patients with stable COPD who visited during July 2013 and November 2014 were enrolled in our study.Each patient underwent pulmonary function test,chest CT examination and the symptom assessment using CAT questionnaire.According to the 2014 GOLD combined assessment method,these patients was divided into A-D group.Quantitative CT measures included ％ low attenuation area ＜950 HU (LAA％),the inner diameter of bronchial (LD),the bronchial wall thickness,ratio of thickness and outer diameter(TDR),％ wall area for bronchial external diameter(WA％).We used the square root of the body surface (√BSA) and body surface area (BSA) to adjust these parameters respectively.Results All the parameters except LD/B√BSA were gradually increased as airflow limited worsen,and there were significantly statistical differences (P＜ 0.05).Significantly statistical differences existed in the parameters but TDR or whose except TDR and WA％ if we divided the patients with CAT questionnaire or the frequency of AECOPD.They correlated well with FEV1 ％,RV/TLC,DLCO,CAT and the frequency of AECOPD.Conclusions CT shows varying degrees of bronchial wall thickening,area increasing and emphysema.