Department of Respiratory Medicine, Atami Hospital, International University of Health and Welfare, Atami, Japan.
Respir Med. 2010 Jun;104(6):794-800. doi: 10.1016/j.rmed.2009.12.005. Epub 2010 Jan 6.
Asthma is characterized by variable airflow obstruction and airway wall thickening. Multidetector-row computed tomography (MDCT) is useful for the evaluation of airway wall structural changes in asthma. The objective of the study is to assess the relationship between airflow limitation and airway dimensions from the third to fifth generation bronchi in asthma using MDCT.
Thirty-eight subjects with asthma underwent MDCT to measure the airway wall area (WA) and luminal area (Ai), WA and Ai corrected by body surface area (BSA), up to the fifth generation of the apical bronchus (B1) and the posterior basal bronchus (B10) of the right lung.
WA/BSA, WA percentage (WA%) and Ai/BSA in the fifth generation were significantly correlated with forced expiratory volume in 1 s (FEV(1))% predicted. The correlation coefficients between WA% and FEV(1)% predicted increased when tracking the airways from the third to the fifth generation (r=-0.25, p>0.05; r=-0.40, p<0.01; r=-0.63, p<0.001 for B1; r=-0.23, p>0.05; r=-0.47, p<0.01; r=-0.69, p<0.001 for B10). At the generation 5, WA% was greater and Ai/BSA was smaller in severe asthma than mild-to-moderate asthma.
These results suggest that airway flow limitation in asthma is closely related to the more distal airways (third to fifth generation).
哮喘的特征是气流阻塞和气道壁增厚具有可变性。多层螺旋 CT（MDCT）可用于评估哮喘气道壁结构变化。本研究旨在使用 MDCT 评估哮喘患者从第 3 到第 5 代支气管的气流受限与气道尺寸之间的关系。
38 例哮喘患者接受 MDCT 检查，以测量气道壁面积（WA）和气道内腔面积（Ai），WA 和 Ai 按体表面积（BSA）校正，测量至右肺尖支气管（B1）和后基底支气管（B10）的第 5 代。
WA/BSA、WA%和第 5 代的 Ai/BSA 与 1 秒用力呼气量（FEV1）%预计值显著相关。WA%与 FEV1%预计值之间的相关系数在从第 3 代到第 5 代追踪气道时增加（r=-0.25，p>0.05；r=-0.40，p<0.01；r=-0.63，p<0.001 用于 B1；r=-0.23，p>0.05；r=-0.47，p<0.01；r=-0.69，p<0.001 用于 B10）。在第 5 代，重度哮喘的 WA%更高，Ai/BSA 更小。
这些结果表明，哮喘中的气道气流受限与更远端的气道（第 3 到第 5 代）密切相关。
