Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Poland.
J Physiol Pharmacol. 2009 Nov;60 Suppl 5:71-6.
Airway remodeling in asthma and chronic obstructive pulmonary disease (COPD) results in thickening of bronchial walls and may affect lung function. In the present study we set out to evaluate the relationship between small airway wall thickness and the lung function parameters in patients with asthma and COPD. The study was performed in 10 patients with asthma (4M/6F, the mean age 37+/-13 yr) and 12 patients with COPD (7M/5F, the mean age 57+/-9 yr) with stable, mild to moderate disease. The study group characteristics were based on clinical assessment and lung function testing (spirometry, body plethysmography, methacholine challenge test). All patients underwent chest high resolution computerized tomography with small bronchi (external diameter 1-5 mm) cross section measurements at five selected lung levels. The following parameters were measured in end-inspiratory scans: external (D) and internal (L) diameters, wall area (WA), percentage of the wall area (WA%), wall thickness (WT), and WT/D ratio (BWT). We found no significant correlations between airway wall thickness and spirometric parameters in either group. In the asthma group, the relationships between WA% and BWT, on the one side, and postbronchodilator residual volume, on the other, were noted (r=0.72; P<0.05 and r=0.72; P<0.05, respectively). In the COPD group, WA% related with airway resistance (r=0.72; P<0.05). The correlations between WA% and PC(20) (r=-0.61; P<0.05) and BWT and PC(20) (r=-0.72; P<0.05) were found in the COPD group. There was also a relationship between WA% and airway resistance (Raw) (r=0.72; P<0.05) and BWT and Raw (r=0.45; P=0.1). The number of pack-years correlated with WA and WT in COPD patients. In conclusion, the study shows that the thickening of airway wall in asthma is reflected by an increase in the indices of air trapping and in COPD this thickening results in a higher airway resistance and responsiveness. In COPD, the thickening of airway wall also is related to exposure to tobacco smoke.
哮喘和慢性阻塞性肺疾病（COPD）的气道重塑导致支气管壁变厚，并可能影响肺功能。在本研究中，我们旨在评估哮喘和 COPD 患者的小气道壁厚度与肺功能参数之间的关系。该研究纳入了 10 名哮喘患者（4 男/6 女，平均年龄 37±13 岁）和 12 名 COPD 患者（7 男/5 女，平均年龄 57±9 岁），这些患者的疾病处于稳定期，病情从轻到中度。研究组的特征基于临床评估和肺功能测试（肺活量计、体描法、乙酰甲胆碱挑战测试）。所有患者均接受了胸部高分辨率计算机断层扫描，以测量五个选定肺水平的小支气管（外径 1-5 毫米）的横截面。在吸气末扫描中测量了以下参数：外直径（D）和内直径（L）、壁面积（WA）、壁面积百分比（WA%）、壁厚度（WT）和壁厚度与直径比（BWT）。我们发现两组患者的气道壁厚度与肺功能参数均无显著相关性。在哮喘组中，WA%与 BWT 和支气管扩张后残气量之间存在相关性（r=0.72；P<0.05 和 r=0.72；P<0.05）。在 COPD 组中，WA%与气道阻力相关（r=0.72；P<0.05）。在 COPD 组中还发现了 WA%与 PC（20）之间的相关性（r=-0.61；P<0.05）和 BWT 与 PC（20）之间的相关性（r=-0.72；P<0.05）。WA%与气道阻力（Raw）之间也存在相关性（r=0.72；P<0.05），BWT 与 Raw 之间也存在相关性（r=0.45；P=0.1）。COPD 患者的吸烟包年数与 WA 和 WT 相关。总之，本研究表明哮喘中气道壁的增厚反映在空气滞留指数的增加，而 COPD 中的这种增厚导致更高的气道阻力和反应性。在 COPD 中，气道壁的增厚也与接触烟草烟雾有关。
