Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Kumagaya City, Kanazawa, Japan.
Respirology. 2012 Jan;17(1):79-86. doi: 10.1111/j.1440-1843.2011.02052.x.
COPD and bronchial asthma are chronic airway diseases with a different pathogenesis. Comparisons of differences in airway calibre by bronchial generation between these diseases and their importance to pulmonary function have not been fully studied. We investigated airway calibre and wall thickness in relation to pulmonary function in patients with asthma, COPD, asthma plus emphysema and normal subjects using CT.
Sixty-three asthmatic patients, 46 COPD, 23 patients with asthma plus emphysema and 61 control subjects were studied cross-sectionally. We used a software with curved multiplanar reconstruction to measure airway dimensions from 3rd- to 6th-generation bronchi of the right lower posterior bronchus.
Patients with COPD had increased wall thickness, but the airway was not narrow from the 3rd-(subsegmental) to 6th-generation bronchi. Mean bronchial inner diameter (Di) of 3rd- to 6th-generation bronchi in patients with asthma or asthma plus emphysema was smaller than that of COPD patients and normal subjects. Airway luminal area (Ai) of 5th-generation bronchi most closely correlated with pulmonary function in patients with stable asthma. Although Di was similar in patients with asthma and asthma plus emphysema, the Ai of 6th-generation bronchi correlated significantly with pulmonary function in patients with asthma plus emphysema.
Airway calibre in asthma may be smaller than in COPD. Airflow limitations correlated more closely with peripheral Ai in patients with asthma plus emphysema than in patients with asthma alone.
COPD 和支气管哮喘是两种具有不同发病机制的慢性气道疾病。这些疾病的气道直径差异及其对肺功能的重要性尚未得到充分研究。我们使用 CT 研究了哮喘、COPD、哮喘合并肺气肿患者以及正常受试者的气道直径和壁厚度与肺功能的关系。
共纳入 63 例哮喘患者、46 例 COPD 患者、23 例哮喘合并肺气肿患者和 61 例正常对照者。我们使用带有曲面多平面重建的软件测量右下叶后段支气管第 3 至 6 代支气管的气道尺寸。
COPD 患者的壁厚度增加，但从第 3 代（亚段）至第 6 代支气管气道并不狭窄。哮喘或哮喘合并肺气肿患者的第 3 至 6 代支气管的平均支气管内径（Di）小于 COPD 患者和正常对照者。5 代支气管的气道内腔面积（Ai）与稳定期哮喘患者的肺功能相关性最好。尽管哮喘患者和哮喘合并肺气肿患者的 Di 相似，但 6 代支气管的 Ai 与哮喘合并肺气肿患者的肺功能显著相关。
哮喘患者的气道直径可能小于 COPD 患者。与单纯哮喘患者相比，哮喘合并肺气肿患者的外周 Ai 与气流受限相关性更好。
