摘要
目的探讨不同高分辨率CT(HRCT)表型慢性阻塞性肺疾病(COPD)患者上一年急性加重次数的特点,及与HRCT参数的相关性。方法收集COPD稳定期患者159例,对最终满足标准的72例COPD患者完成HRCT检查,并记录上一年急性加重次数。根据HRCT影像中肺气肿程度或(和)支气管管壁增厚情况进行分型,并测定PI-950和支气管管壁厚度与相邻肺动脉直径的比值。结果COPD表型分别为:无肺气肿型32例,肺气肿型40例;无支气管管壁增厚型40例,支气管管壁增厚型32例;A型32例,E型19例,M型21例。COPD患者的HRCT参数EI和支气管管壁厚度/相邻肺动脉直径比值与上一年急性加重频率均呈正相关(r=0.28,P=0.017;r=0.416,P=0.000)。HRCT表型为肺气肿型的患者平均上一年急性加重次数为(1.83±0.81)次,高于无肺气肿型\[(1.09±0.96)次,P=0.001\];支气管管壁增厚型患者急性加重次数为(1.81±0.86)次,高于无支气管管壁增厚型\[(1.25±0.95)次,P=0.011)\];A型急性加重次数为(1.09±0.96)次,低于E型及M型\[(1.63±0.761)次,(2.00±0.84)次,P=0.002\],E型与M型之间比较差异无统计学意义。结论 COPD患者PI-950及支气管管壁厚度/相邻肺动脉直径比值与上一年急性加重次数呈正相关。HRCT表型多为肺气肿型及支气管管壁增厚型的患者,且COPD急性加重频繁,而A型患者的急性加重频率较低。
Objective To classify the high resolution computed tomography（ HRCT） phenotypes of chronic obstructive pulmonary disease（ COPD）, and to investigate the acute exacerbation frequency characteristics of various phenotypes and the relationship with HRCT parameters. Methods seventy-two consecutive COPD patients underwent HRCT and their the number of acute exacerbations last year were recorded. COPD subjects were classified into different phenotypes based on the visual HRCT findings（ with or without emphysema and / or bronchial wall thickening）. With the volumetric HRCT data,the total lung volume（ TLV） was calculated automatically by Extended Brilliance Workspace TM,the total emphysema volume（ TEV）was obtained by applying density thresholds of-950 HU,and the TEV / TLV was calculated as an emphysema index（ EI）. Emphysema threshold was set to-950 HU,then find out the corresponding percentage,it was the pixel index-950（ PI-950）. We measured the bronchial wall thickness and the adjacent pulmonary artery diameter and calculated their ratio. Results We divided the cases into different phenotypes： emphysematous phenotype（ 40 cases）,non-emphysematous phenotype（ 32 cases）; bronchial wall thickening phenotype（ 32cases） and non-bronchial wall thickening phenotype（ 40 cases）; A phenotype（ 32 cases）,E phenotype（ 19cases）,M phenotype（ 21 cases）. The PI-950 and the ratio of bronchial wall thickening and adjacent pulmonary artery diameter were positively correlated with the number of acute exacerbation history in previous year（ r = 0. 28,P = 0. 017; r = 0. 416,P = 0. 000）. The number of acute exacerbation history in previous year of non-emphysematous phenotype and emphysematous phenotype is 1. 09 ± 0. 96,1. 83 ± 0. 81 respectively,and has statistical difference（ t =- 3. 494,P = 0. 001）. Non-bronchial wall thickening phenotype and bronchial wall thickening phenotype is 1. 25 ± 0. 95,1. 81 ± 0. 86 respectively,and has statistical difference（ t =- 2. 597,P = 0. 011�
出处
《中华肺部疾病杂志（电子版）》
CAS
2015年第3期32-35,共4页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
肺疾病
慢性阻塞性
CT
高分辨率
频率
急性加重
表型
Chronic obstructive pulmonary disease
High resolution computed tomography（HRCT）
Acute exacerbation frequency
Phenotype
