摘要
目的 探究呼出气一氧化氮(FeNO)结合CT三维重建定量小气道参数评估慢性阻塞性肺疾病(COPD)患者肺功能的价值。方法 回顾性选取2022年6月至2023年6月马鞍山市人民医院收治的80例COPD患者,对患者进行COPD全球倡议(GOLD)分级标准评估,33例评定为1~2级的患者纳入轻度组,47例评定为3~4级的患者纳入重度组。比较两组患者的FeNO、白细胞总数、中性粒细胞百分比及相关肺功能[第1秒用力呼气容积占预计值的百分比(FEV1%pred)、1秒用力呼气量(FEV1)/用力肺活量(FVC)、用力呼出25%、50%、75%肺活量时的平均呼气流速(MEF25%pred、MEF50%pred、MEF75%pred)]水平。所有患者均接受CT三维重建,记录相关小气道参数[气道壁面积百分比(WA%)、壁厚外径比(TDR)、主肺动脉∶升主动脉(PA∶A)、低衰减区域百分比(LAA%-950HU)],采用Pearson相关性分析探究患者的FeNO、CT三维重建参数与患者肺功能的相关性,采用受试者工作特征(ROC)曲线探究其对COPD病情严重程度的诊断价值。结果 重度组患者的FeNO水平为(29.55±1.56) ppb,高于轻度组[(23.66±1.23) ppb],差异有统计学意义(P<0.05);轻度组和重度组患者的白细胞总数及中性粒细胞百分比组间比较,差异均无统计学意义(P>0.05)。重度组的FEV1/FVC、FEV1%pred、MEF25%pred、MEF50%pred、MEF75%MEFpred分别为(40.11±3.56)%、(39.49±5.49)%、(20.88±2.38)%、(29.74±2.46)%、(39.23±3.11)%,均低于轻度组[(69.89±5.12)%、(54.22±6.12)%、(26.81±2.13)%、(36.22±2.34)%、(53.55±4.12)%],差异均有统计学意义(P<0.05)。重度组患者的WA%_(7~8)、TDR_(7~8)、PA∶A、全肺LAA%-950HU分别为(86.98±3.45)%、32.78±4.15、0.85±0.05、(10.88±2.16)%,均高于轻度组[(85.44±3.11)%、31.16±5.15、0.79±0.08、(2.98±0.61)%],差异均有统计学意义(P<0.05)。经Pearson相关性分析,患者的FEV1%pred、FEV1/FVC、MEF25%pred、MEF50%pred、MEF75%pred与一氧化氮、PA∶A、全肺LAA%-950HU、TDR_(7~8)、WA%_(7~8
Objective To explore the value of fractional exhaled nitric oxide(FeNO)combined with CT 3D reconstruction quantitative small airway parameters in evaluating pulmonary function in patients with chronic obstructive pulmonary diseases(COPD).Methods A total of 80 patients with COPD admitted to Maanshan People's Hospital from June 2022 to June 2023 were retrospectively selected and evaluated according to the global initiative for chronic obstructive lung disease(GOLD)grading criteria.Thirty-three patients rated as grade 1-2 were included in the mild group,and 47 patients rated as grade 3-4 were included in the severe group.Exhaled nitric oxide,total white blood cells,neutrophil percentage and related lung function[the percentage of forced expiratory volume in the first second to the predicted value(FEV1%pred),forced expiratory volume in 1 second(FEV1)/forced vital capacity(FVC),mean expiratory flow rate at 25%,50%,75%of forced expiratory vital capacity(MEF25%pred,MEF50%pred,MEF75%pred)]levels were compared between the two groups.All patients received CT 3D reconstruction,and relevant small airway parameters[airway wall area percentage(WA%),thickness-to-diameter ratio(TDR),aortopulmonary∶ascending aorta(PA∶A),percentage of low attenuation regions(LAA%-950HU)]were recorded.The correlation between exhaled nitric oxide and CT 3D reconstruction parameters and lung function of patients was explored by Pearson correlation analysis,and the diagnostic value of these parameters on the severity of COPD was explored by receiver operating characteristic(ROC)curve.Results The FeNO level in the severe group was(29.55±1.56)ppb,which was higher than that in the mild group[(23.66±1.23)ppb],and the difference was statistically significant(P<0.05);there were no statistically significant differences in the total number of white blood cells and percentage of neutrophils between the mild group and the severe group(P>0.05).The FEV1/FVC,FEV1%pred,MEF25%pred,MEF50%pred and MEF75%MEFpred in the severe group were(40.11±3.56)%,(39.49±5.49
作者
王琰
顾东伟
郑磊
WANG Yan;GU Dong-wei;ZHENG Lei(Department of Respiratory Medicine,Maanshan People's Hospital,Maanshan Anhui 243000,China)
出处
《临床和实验医学杂志》
2024年第18期1924-1928,共5页
Journal of Clinical and Experimental Medicine
基金
安徽省自然科学基金(编号:2208085QH264)。
关键词
肺疾病
慢性阻塞性
一氧化氮
CT三维重建
小气道参数
肺功能
Pulmonary diseases,chronic obstructive
Nitric oxide
CT 3D reconstruction
Small airway parameters
Lung function
