摘要
目的分析支气管哮喘合并慢性阻塞性肺疾病(ACO)患者胸部高分辨CT(HRCT)所示肺气肿程度并探讨其与肺功能的相关性。方法收集2013年3月～2015年3月上海健康医学院附属第六人民医院南院呼吸科就诊的初步诊断为支气管哮喘和/或慢性阻塞性肺疾病(COPD)患者69例,根据慢性阻塞性肺疾病全球创议(GOLD)及全球哮喘防治创议(GINA)指南诊断标准将患者分为三组:哮喘组(18例),COPD组(37例),ACO组(14例)。所有患者均接受肺功能测定及胸部HRCT扫描。由Myrian软件对CT图像进行三维重建,辨识肺组织及低密度区,并计算CT值小于-950 Hu的低密度区比例(LAA%)。结果哮喘组和COPD组及ACO组比较,左肺LAA%、右肺LAA%及全肺LAA%差异有高度统计学意义(P <0.01),ACO组和COPD组比较,左肺LAA%、右肺LAA%及全肺LAA%差异无统计学意义(P> 0.05)。ACO组左肺LAA%、右肺LAA%及全肺LAA%与FEV1%预计值(r=-0.611、-0.635、-0.672)及FEV1/FVC%(r=-0.699、-0.673、-0.745)均呈负相关(均P <0.05),而与第1秒用力呼气容积占肺活量的比值(RV/TLC%)呈正相关(r=0.451、0.381、0.446,均P <0.05)。结论 ACO患者HRCT所示肺气肿与COPD患者相似,较哮喘患者严重;ACO患者HRCT所示肺气肿可在一定程度反映肺通气功能情况。
Objective To analyze the degree of emphysema on chest high-resolution CT(HRCT)in patients with bronchial asthma complicated with chronic obstructive pulmonary disease(ACO)and to explore its correlation with lung function.Methods From March 2013 to March 2015,in Respiratory Clinic of South Campus of the Sixth People′s Hospital Affiliated to Shanghai University of Medicine&Health Sciences,69 patients with preliminary diagnosis of bronchial asthma and/or chronic obstructive pulmonary disease(COPD)were collected,according to the GOLD and GINA guide diagnosis standard,they were divided into three groups:asthma group(18 cases),COPD group(37 cases),ACO group(14 cases).All patients underwent lung function measurement and chest HRCT scan.Myrian software carried out three-dimensional reconstruction of the CT image,identified the lung tissue and the low-density region,and calculates the proportion of the low-density region(LAA%)whose CT value was less than-950 Hu.Results The LAA%of left lung,LAA%of right lung and LAA%of whole lung were highly statistically significant in asthma group,COPD group and ACO group(P﹤0.01),while the LAA%of left lung,LAA%of right lung and LAA%of whole lung were not statistically significant in ACO group and COPD group(P﹥0.05).In ACO group,LAA%of left lung,LAA%of right lung and LAA%of whole lung were negatively correlated with predicted values of FEV1%(r=-0.611,-0.635,-0.672)and FEV1/FVC%(r=-0.699,-0.673,-0.745)(all P﹤0.05).There was a positive correlation with RV/TLC%(r=0.451,0.381,0.446,all P﹤0.05).Conclusion HRCT of ACO patients shows emphysema similar to that of COPD patients,which is significantly more severe than that of asthma patients.HRCT images of ACO patients with emphysema can reflect the pulmonary ventilation function to a certain extent.
作者
黄爱霞
姚国相
金崇武
刘宏伟
刘温娟
张华伟
张燕
鲁立文
HUANG Aixia;YAO Guoxiang;JIN Chongwu;LIU Hongwei;LIU Wenjuan;ZHANG Huawei;ZHANG Yan;LU Liwen(.Department of Respiratory,South Campus,the Sixth People′s Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 201499,China;Department of Surgery,South Campus,the Sixth People′s Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 201499,China)
出处
《中国医药导报》
CAS
2019年第2期113-116,共4页
China Medical Herald
基金
上海健康医学院种子基金项目(HMSF-16-22-022)
