摘要
目的 分析不同表型慢性阻塞性肺病(COPD)患者高分辨率CT(HRCT)参数与T淋巴细胞亚群水平、肺功能参数的相关性。方法 选取2021年5月至2022年4月河南省胸科医院收治的120例COPD患者,将其分为COPD A、E、M型。比较不同表型患者临床症状[COPD评估测试(CAT)、呼吸困难程度量表(m MRC)、6 min步行试验(6MWT)]、肺功能参数[第1秒用力呼气容积(FEVl)、第1秒用力呼气容积占预计值百分比(FEVl%)、第1秒用力呼气容积占用力肺活量比率(FEVl/FVC)]、T淋巴细胞亚群水平(CD3^(+)、CD4^(+)/CD8^(+))和HRCT参数[-950 HU以下低衰减区在吸气相上的百分比(LAA%-950in)、-856~-950 HU范围内呼气相与吸气相衰减区占全肺容积百分比的差值(RVC-856~-950)、呼气相与吸气相的平均肺密度比值(MLD ex/in)],分析HRCT参数与上述指标的相关性。结果 120例COPD患者表型分型A型66例,E型31例,M型23例。CAT、mMRC评分及LAA%-950in、RVC-856~-950、MLD ex/in:A型E型>M型,差异均有统计学意义(P<0.05)。外周血CD3^(+)、CD4^(+)/CD8^(+)水平:A型>E型>M型,差异均有统计学意义(P<0.05)。不同表型COPD患者LAA%-950in、RVC-856~-950、MLD ex/in与CAT、mMRC评分呈正相关,与6MWD、FEVl、FEVl%、FEVl/FVC、CD3^(+)、CD4^(+)/CD8^(+)水平呈负相关(P<0.05)。结论 HRCT、肺功能参数及T淋巴细胞亚群水平在不同表型COPD患者中差异明显,在患者病情严重程度评估方面具有一定指导意义。
Objective To analyze the correlation between high resolution CT(HRCT)parameters,T lymphocyte subsets levels and pulmonary function parameters in patients with different phenotypes of chronic obstructive pulmonary disease(COPD). Methods 120 patients with COPD treated in Henan Provincial Chest Hospital from May 2021 to April 2022 were selected and divided into COPD types A,E and M. The clinical symptoms[COPD assessment test(CAT),modified medical research council dyspnea scale(mMRC),6 min walking test(6MWT)],pulmonary function parameters[forced expiratory volume in 1st second(FEVl),percentage of forced expiratory volume in 1 second to predicted value(FEVl%),ratio of forced expiratory volume in 1st second to forced vital capacity(FEVl/FVC)],T lymphocyte subsets(CD3^(+),CD4^(+)/CD8^(+))and HRCT parameters[percentage of low attenuation range under-950 HU in inspiratory phase(LAA%-950in),difference of percentage of attenuation range in total lung volume in expiratory phase and inspiratory phase under the range of-856~-950HU(RVC-856~-950),ratio of average lung density in expiratory phase and inspiratory phase(MLD ex/in)]were compared among patients with different phenotypes,and the correlation between HRCT parameters and the above indicators was analyzed. Results Among 120 patients with COPD,there were 66 cases of type A,31 cases of type E,and 23 cases of type M. CAT score,mMRC score and LAA%-950in,RVC-856~-950 and MLD ex/in were shown as type Atype E > type M(P<0.05). The peripheral blood CD3^(+)and CD4^(+)/CD8^(+)showed type A > type E> type M(P<0.05). LAA%-950in,RVC-856~-950 and MLD ex/in were positively correlated with scores of CAT and m MRC in patients with different phenotypes of COPD,and were negatively correlated with 6MWD,FEV1,FEVl%,FEVl/FVC,CD3^(+)and CD4^(+)/CD8^(+)(P<0.05). Conclusion HRCT,pulmonary function parameters and T lymphocyte subsets are significantly different in patients with different phenotypes of COPD and have certain guiding significance in the assessment of the severity of the disease.
作者
郑一
刘继伟
于喜红
何燕斐
王建军
杨瑞
ZHENG Yi;LIU Jiwei;YU Xihong;HE Yanfei;WANG Jianjun;YANG Rui(Department of Imaging,Henan Provincial Chest Hospital,Zhengzhou,Henan,China,450000)
出处
《分子诊断与治疗杂志》
2023年第1期43-47,共5页
Journal of Molecular Diagnostics and Therapy
基金
河南省医学科技攻关计划(LHGJ20200237)。
关键词
慢性阻塞性肺疾病
高分辨率CT
肺功能
T淋巴细胞亚群
Chronic obstructive pulmonary disease
High resolution CT
Pulmonary function
T lymphocyte subsets
