Kasai Tomihiko, Yamada Minehiko, Narushima Michiaki, Suzuki Hajime
Showa University, Fujigaoka Hospital, Department of Respiratory Diseases, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan.
Nihon Kokyuki Gakkai Zasshi. 2003 Aug;41(8):526-30.
We examined the relationship between the thoracic cross-sectional area (TCSA) and pulmonary function data or dyspnea grade in 24 patients with chronic obstructive pulmonary disease (COPD). The TCSA, i.e., the area surrounded by the rib cage, was measured on computed tomography (CT) images made 1 cm below the top of the aortic arch. Analysis of our data showed a good correlation between TCSA and total lung capacity (r = 0.65, p < 0.001), as well as functional residual capacity (r = 0.67, p < 0.0005) and residual volume (r = 0.62, p < 0.005). The patients were grouped according to their grade of dyspnea (Fletcher's five-degree scale), and the ratio of TCSA over square of height (TCSA/Ht2) was calculated for each patient. In the group with grade IV dyspnea, the TCSA/Ht2 ratios were significantly greater than those in the groups with grade II and III dyspnea, combined. In summary, in the patients with COPD, pulmonary function data indicative of lung hyperinflation correlated with the TCSA, and both parameters were increased in patients with severe dyspnea.
我们研究了24例慢性阻塞性肺疾病(COPD)患者的胸廓横截面积(TCSA)与肺功能数据或呼吸困难分级之间的关系。TCSA即由胸廓所包围的面积,在主动脉弓顶部下方1 cm处的计算机断层扫描(CT)图像上进行测量。我们的数据分析显示,TCSA与肺总量(r = 0.65,p < 0.001)、功能残气量(r = 0.67,p < 0.0005)和残气量(r = 0.62,p < 0.005)之间存在良好的相关性。根据患者的呼吸困难分级(弗莱彻五级量表)进行分组,并计算每位患者的TCSA与身高平方的比值(TCSA/Ht2)。在IV级呼吸困难组中,TCSA/Ht2比值显著高于II级和III级呼吸困难组合组。总之,在COPD患者中,提示肺过度充气的肺功能数据与TCSA相关,且这两个参数在严重呼吸困难患者中均升高。