高反应性患者和健康个体的支气管反应性：高分辨率计算机断层扫描显示

Bronchial reactivity in hyperresponsive patients and healthy individuals: demonstration with high resolution computed tomography.

作者信息

Schueller G, Neumann K, Helbich T, Riemer H, Backfrieder W, Sertl K, Herold C J

机构信息

Department of Radiology, University of Vienna Medical School, Vienna, Austria.

出版信息

Eur J Radiol. 2004 Nov;52(2):151-6. doi: 10.1016/j.ejrad.2004.02.005.

DOI:10.1016/j.ejrad.2004.02.005

PMID:15489072

Abstract

OBJECTIVE

High resolution computed tomography (HRCT) was used to assess the extent of bronchial reactivity after inhalative bronchoprovocation and dilation in hyperresponsive patients and healthy subjects.

PATIENTS AND METHODS

Patients with mild intermittent asthma, 15 with a >20% decrease in FEV1 and a >10 mmHg (PC20+) in PaO2, 12 with a <20% decrease in FEV1 and a >10 mmHg (PC20-) in PaO2 after provocation, and eight healthy humans were included in the study. Changes in cross-sectional area in a total of 1256 bronchi and in bronchial wall area (792 bronchi) were evaluated after histamine-triggered bronchoprovocation and salbutamol-induced bronchodilation at high lung volumes (FVC 80%). Data were compared with the results of pulmonary function tests (FEV1, PaO2, PaCO2).

RESULTS

In all groups, a significant decrease in bronchial cross-sectional area (P<0.001) and a significant increase in bronchial wall area (P<0.001) were observed subsequent to bronchoprovocation. After bronchodilation, the increase in cross-sectional area (P<0.001) and the further increase in airway wall area (P<0.01) were significant in all groups. In PC20+ and PC20- asthmatics, significant differences (P<0.05) in PaO2, >10 mmHg between baseline and provocation were observed. In healthy persons, the PaO2 decrease was <10 mmHg (P>0.05). After histamine provocation, the decrease in FEV1 was measured in the PC20+ group, whereas a <20% FEV1 decrease was found in the PC20- and the control groups, respectively. No significant correlations were observed between radiological data and the results of pulmonary function tests.

CONCLUSIONS

HRCT demonstrated bronchial reactivity in hyperresponsive patients and, unexpectedly, in healthy subjects. The applied pulmonary function tests failed to characterize bronchial reactions in the healthy subjects. Based on these results, HRCT is a useful tool by which to achieve a comprehensive understanding of the pathophysiological processes in asthmatic patients.

摘要

目的

采用高分辨率计算机断层扫描（HRCT）评估高反应性患者和健康受试者吸入支气管激发试验及扩张试验后支气管反应性的程度。

患者与方法

纳入轻度间歇性哮喘患者，其中15例在激发试验后FEV1下降>20%且PaO2下降>10 mmHg（PC20+），12例在激发试验后FEV1下降<20%且PaO2下降>10 mmHg（PC20-），以及8名健康人。在高肺容积（FVC 80%）下，对组胺激发试验和沙丁胺醇诱导的支气管扩张试验后总共1256个支气管的横截面积变化和792个支气管的支气管壁面积变化进行评估。将数据与肺功能测试结果（FEV1、PaO2、PaCO2）进行比较。

结果

在所有组中，支气管激发试验后均观察到支气管横截面积显著减小（P<0.001），支气管壁面积显著增加（P<0.001）。支气管扩张后，所有组的横截面积增加（P<0.001）和气道壁面积进一步增加（P<0.01）均显著。在PC20+和PC20-哮喘患者中，观察到基线与激发试验之间PaO2存在显著差异（P<0.05），差值>10 mmHg。在健康人中，PaO2下降<10 mmHg（P>0.05）。组胺激发试验后，PC20+组测量到FEV1下降，而PC20-组和对照组FEV1下降分别<20%。未观察到放射学数据与肺功能测试结果之间存在显著相关性。