De Luca N, Capuzi P, D'Angeli A L, D'Antoni L, Pavone P, De Santis M, Di Girolamo M, Catalano C, Passariello R
Istituto di Terapia Medica, Università degli Studi La Sapienza, Roma, Italy.
Eur Rev Med Pharmacol Sci. 1999 Mar-Apr;3(2):83-7.
The evaluation of airway obstruction reversibility in chronic obstructive pulmonary disease (COPD) patients is currently performed by means of an indirect assessment of drug inducing variations in pulmonary function tests. Imaging techniques, especially high resolution computed tomography (HRCT), usually provide a complete evaluation of lung parenchyma (bronchial and vascular structures), but so far they have never been applied to visualize the effects on the bronchopulmonary tree of some pharmacologic stimuli (beta 2 adrenergic agonist), currently used in clinical practice to disclose the presence of airway reversibility. In order to assess the possible role of HRCT in this setting, five COPD patients have been subjected to a double functional radiologic evaluation before and after salbutamol-induced broncho-dilation, with a rigorous assessment of bronchial diameter changes by means of "bronchus-vessel" ratio, currently used for diagnosing bronchiectasis in COPD patients. The results of this experimental study enable us to visualize drug induced broncho-dilation, with a direct assessment of airway reversibility in these patients, and to show a good correlation between functional and HRCT findings, raising the possibility of evaluation COPD patients with abnormal spirometric results or with early signs of lung involvement.
目前，慢性阻塞性肺疾病（COPD）患者气道阻塞可逆性的评估是通过对药物诱导的肺功能测试变化进行间接评估来进行的。成像技术，尤其是高分辨率计算机断层扫描（HRCT），通常能对肺实质（支气管和血管结构）进行全面评估，但迄今为止，它们从未被用于可视化目前临床实践中用于揭示气道可逆性的某些药理刺激（β2肾上腺素能激动剂）对支气管肺树的影响。为了评估HRCT在这种情况下的可能作用，对5例COPD患者在沙丁胺醇诱导支气管扩张前后进行了双重功能放射学评估，并通过目前用于诊断COPD患者支气管扩张的“支气管-血管”比率对支气管直径变化进行了严格评估。这项实验研究的结果使我们能够可视化药物诱导的支气管扩张，直接评估这些患者的气道可逆性，并显示功能和HRCT结果之间有良好的相关性，从而增加了对肺量计结果异常或有早期肺部受累迹象的COPD患者进行评估的可能性。
