应用呼吸双相CT定量评估COPD患者肺气肿及空气潴留状况
China Medical Devices（2022）
中国中医科学院广安门医院
Abstract
目的 评估呼吸双相CT定量技术评价慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)肺气肿及小气道功能障碍程度的价值.方法 研究纳入35例COPD患者(病例组)和32例非吸烟肺功能(Pulmonary Function Test,PFT)正常者(对照组)作为研究对象.在呼吸双相CT上测量肺气肿指数(Emphysema Index,EI)、空气潴留指数(Air Trapping,AT)、吸气相平均肺密度(Inspiration Mean Lung Density,MLDin)和呼气相平均肺密度(Expiation Mean Lung Density,MLDex)及二者的比值(E/IMLD)、吸气相肺体积(Inspiration Lung Volume,LVin)和呼气相肺体积(Expiation Lung Volume,LVex)及二者的比值(E/ILV).比较对照组与病例组、轻中度病例组与重度病例组CT定量参数,并与PFT参数:用力肺活量(Furced Vital Capacity,FVC);1 s用力呼气容积(Forced Expiratory Voluime in One Second,FEV1)、1 s用力呼气容积占用力肺活量的比值(FEV1/FVC)、最大呼气中期流速(Mid Expiratory Phase of Forced Expiratory Flow,FEF25％～75％)、残气容积(Residual Volume,RV)、肺总量(Total Lung Capacity,TLC)、残气容积与肺总量的比值(RV/TLC)进行相关性分析.结果 与对照组相比,病例组患者全肺的LV、EI、AT、E/ILV、E/IMLD升高,MLD降低(P＜0.05).轻中度病例组与重度病例组间的LV、EI、AT、E/ILV、E/IMLD、MLD有显著差异(P＜0.05),反映肺气肿程度的指标EI与PFT指标FVC％、FEVi％、FEVi/FVC有较高相关性,反映空气潴留指标AT、E/ILV、E/IMLD与PFT中小气道功能指标FEF25％～75％、RV和RV/TLC密切相关.结论 COPD患者呼吸双相CT的密度和体积变化与肺气肿的程度及小气道功能障碍密切相关,其中呼气相指标可以更好地反映小气道功能.
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