First Department of Medicine, Hokkaido University School of Medicine, N-15 W-7, Kita-ku, Sapporo 060-8638, Japan.
Respir Med. 2011 Sep;105(9):1275-83. doi: 10.1016/j.rmed.2011.04.007. Epub 2011 Jun 8.
Few studies have directly compared airway remodelling assessed by computed tomography (CT) between asthma and chronic obstructive pulmonary disease (COPD). The present study was conducted to determine whether there are any differences between the two diseases with similar levels of airflow limitation under clinically stable conditions.
Subjects included older male asthmatic patients (n = 19) showing FEV(1)/FVC <70% with smoking history less than 5-pack/year. Age- and sex-matched COPD patients (n = 28) who demonstrated similar airflow limitation as asthmatic patients and age-matched healthy non-smokers (n = 13) were recruited. Using proprietary software, eight airways were selected in the right lung, and wall area percent (WA%) and airway luminal area (Ai) were measured at the mid-portion of the 3rd to 6th generation of each airway. For comparison, the average of eight measurements per generation was recorded.
FEV(1)% predicted and FEV(1)/FVC was similar between asthma and COPD (82.3 ± 3.3% vs. 77.6 ± 1.8% and 57.7 ± 1.6% vs. 57.9 ± 1.4%). At any generation, WA% was larger and Ai was smaller in asthma, both followed by COPD and then controls. Significant differences were observed between asthma and controls in WA% of the 3rd to 5th generation and Ai of any generation, while no differences were seen between COPD and controls. There were significant differences in Ai of any generation between asthma and COPD.
Airway remodelling assessed by CT is more prominent in asthma compared with age- and sex-matched COPD subjects in the 3rd- to 6th generation airways when airflow limitations were similar under stable clinical conditions.
很少有研究直接比较在临床稳定条件下气流受限程度相似的哮喘和慢性阻塞性肺疾病（COPD）患者通过计算机断层扫描（CT）评估的气道重塑。本研究旨在确定在气流受限程度相似的情况下，两种疾病之间是否存在差异。
纳入的受试者为年龄较大的男性哮喘患者（n=19），其表现为 FEV1/FVC<70%，且吸烟史<5 包/年。纳入年龄和性别匹配的 COPD 患者（n=28），其表现为与哮喘患者相似的气流受限，以及年龄匹配的健康不吸烟者（n=13）。使用专有的软件，在右肺中选择 8 条气道，并在第 3 至 6 代气道的中段测量壁面积百分比（WA%）和气道内腔面积（Ai）。为了比较，记录了每一代 8 个测量值的平均值。
哮喘和 COPD 患者的 FEV1%预测值和 FEV1/FVC 相似（82.3±3.3% vs. 77.6±1.8%和 57.7±1.6% vs. 57.9±1.4%）。在任何一代，WA%在哮喘中更大，Ai 在哮喘中更小，其次是 COPD，然后是对照组。在第 3 至 5 代的 WA%和任何一代的 Ai 中，哮喘与对照组之间均存在显著差异，而 COPD 与对照组之间无差异。在任何一代的 Ai 中，哮喘与 COPD 之间均存在显著差异。
在气流受限程度相似的临床稳定条件下，与年龄和性别匹配的 COPD 患者相比，通过 CT 评估的气道重塑在第 3 至 6 代气道中在哮喘中更为明显。
