摘要
目的研究慢性阻塞性肺疾病(chronic obstructive plumonary disease,COPD)患者CT定量测量与肺功能检查各项指标之间的相关性,以评估CT定量测量在协助诊断COPD中的价值。方法收集牡丹江医学院附属红旗医院放射科2018年1月至2021年5月间经临床诊断为COPD的73例患者为研究对象,所有患者均有完整的CT检查及临床肺功能检查,测量患者WT、WA、WA%等CT定量指标,并收集患者FEVI、FEV1%、FEV1/FVC、MEF50、MEF25、MMEF75/25、RV/TLC、DLCO等相关肺功能指标,采用spearman相关性分析方法以探究COPD患者定量CT测量与肺功能指标之间的相关性。结果(1)不同分级COPD患者之间WT、WA、WA%比较差异有统计学意义(P<0.05),且随着COPD分级的上升,WT、WA%增加;不同分级COPD患者之间FEV1%、FEV1/FVC、MEF50、MEF25、MMEF75/25、RV/TLC、DLCO比较差异有统计学意义(P<0.05),且随着COPD分级的上升,FEV1/FVC、DLCO、MMEF75/25降低,RV/TLC上升。(2)WT、WA与FEV1%,FEV1/FVC呈负相关(P<0.05),WA%与FEV1、FEV1%、FEV1/FVC、MEF50、MMEF75/25呈中等强度负相关(P<0.05),WT、WA%与气流受限严重程度呈正相关(P<0.05),与WT、WA相比,WA%与肺功能指标及气流受限严重程度具有更强的相关性。(3)CT定量测量指标WT区分重度以上COPD患者灵敏度为0.73,特异度0.611,AUC为0.740,WA%区分重度以上COPD患者灵敏度0.703,特异度0.694,AUC为0.685。结论定量CT测量指标在区分重度、极重度(GOLD3-4级)COPD患者方面具有良好的诊断效能,与WT相比,WA%具有更好的诊断效能。
Objective To study the correlation between CT quantitative measurement and pulmonary function test in patients with chronic obstructive pulmonary disease(chronic obstructive plumonary disease COPD),and to evaluate the value of CT quantitative measurement in the diagnosis of COPD.Methods 73 patients with COPD diagnosed by menstruation in Department of Radiology,Hongqi Hospital affiliated to Mudanjiang Medical College from January 2018 to May 2021 were collected.All patients had complete CT examination and clinical pulmonary function examination.The quantitative indexes of CT such as WT,WA and WA%were measured and the related pulmonary function indexes such as FEVI,FEV1%,FEV1/FVC,MEF50,MEF25,MMEF75/25,RV/TLC and DLCO were collected.The correlation between quantitative CT measurement and pulmonary function index in patients with COPD was explored by spearman correlation analysis.Results(1)There were significant differences in WT,WA and WA%among patients with different grades of COPD(P<0.05),and WT and WA%increased with the increase of COPD grade.There were significant differences in the ratios of FEV1%,FEV1/FVC,MEF50,MEF25,MMEF75/25,RV/TLC and DLCO among patients with different grades of COPD(P<0.05),with the increase of COPD grade,FEV1/FVC,DLCO,MMEF75/25 decreased and RV/TLC increased.(2)WT and WA were negatively correlated with FEV1%,FEV1/FVC(P<0.05),while WA%was moderately negatively correlated with FEV1,FEV1%,FEV1/FVC,MEF50 and MMEF75/25(P<0.05).Compared with WT and WA,WA%had a stronger correlation with pulmonary function index and airflow limitation severity.(3)The sensitivity and specificity of CT quantitative measurement index WT in distinguishing patients with severe COPD were 0.73 and 0.740,respectively.The sensitivity and specificity of WA%in distinguishing patients with severe COPD were 0.703 and 0.694,respectively.Conclusion Quantitative CT has a good diagnostic efficacy in distinguishing patients with severe and extremely severe patients with chronic obstructive pulmonary disease(GOLD3-4).Compared with WT,WA%has a better diagnostic effect.
作者
张春霞
董萍
包婉秋
董天
杨伟振
ZHANG Chun-xia(Department of Public Health Mudanjiang Medical University,Mudanjiang 157011,China)
出处
《牡丹江医学院学报》
2022年第1期39-43,共5页
Journal of Mudanjiang Medical University
基金
牡丹江医学院研究生创新科研项目(YJSCX-MY39)。
关键词
慢性阻塞性肺疾病
CT定量测量
肺功能
chronic obstructive pulmonary disease
CT quantitative measurement
pulmonary function
