计算机断层扫描肺容积在慢性阻塞性肺疾病患者中的临床应用

Clinical utility of computed tomographic lung volumes in patients with chronic obstructive pulmonary disease.

作者信息

Lee Jae Seung, Lee Sang-Min, Seo Joon Beom, Lee Sei Won, Huh Jin Won, Oh Yeon-Mok, Lee Sang-Do

机构信息

Department of Pulmonary and Critical Care Medicine, Asthma Center and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Respiration. 2014;87(3):196-203. doi: 10.1159/000355097. Epub 2013 Dec 7.

DOI:10.1159/000355097

PMID:24334816

Abstract

BACKGROUND

Published data concerning the utility of computed tomography (CT)-based lung volumes are limited to correlation with lung function.

OBJECTIVES

The aim of this study was to evaluate the clinical utility of the CT expiratory-to-inspiratory lung volume ratio (CT Vratio) by assessing the relationship with clinically relevant outcomes.

METHODS

A total of 75 stable chronic obstructive pulmonary disease (COPD) patients having pulmonary function testing and volumetric CT at full inspiration and expiration were retrospectively evaluated. Inspiratory and expiratory CT lung volumes were measured using in-house software. Correlation of the CT Vratio with patient-centered outcomes, including the modified Medical Research Council (MMRC) dyspnea score, the 6-min walk distance (6MWD), the St. George's Respiratory Questionnaire (SGRQ) score, and multidimensional COPD severity indices, such as the BMI, airflow obstruction, dyspnea, and exercise capacity index (BODE) and age, dyspnea, and airflow obstruction (ADO), were analyzed.

RESULTS

The CT Vratio correlated significantly with BMI (r = -0.528, p < 0.001). The CT Vratio was also significantly associated with MMRC dyspnea (r = 0.387, p = 0.001), 6MWD (r = -0.459, p < 0.001), and SGRQ (r = 0.369, p = 0.001) scores. Finally, the CT Vratio had significant correlations with the BODE and ADO multidimensional COPD severity indices (r = 0.605, p < 0.001; r = 0.411, p < 0.001).

CONCLUSION

The CT Vratio had significant correlations with patient-centered outcomes and multidimensional COPD severity indices.

摘要

背景

关于基于计算机断层扫描（CT）的肺容积效用的已发表数据仅限于与肺功能的相关性。

目的

本研究的目的是通过评估与临床相关结局的关系来评价CT呼气与吸气肺容积比（CT Vratio）的临床效用。

方法

回顾性评估了75例稳定期慢性阻塞性肺疾病（COPD）患者，这些患者在完全吸气和呼气时进行了肺功能测试和容积CT检查。使用内部软件测量吸气和呼气CT肺容积。分析CT Vratio与以患者为中心的结局之间的相关性，包括改良医学研究委员会（MMRC）呼吸困难评分、6分钟步行距离（6MWD）、圣乔治呼吸问卷（SGRQ）评分以及多维COPD严重程度指数，如体重指数、气流阻塞、呼吸困难和运动能力指数（BODE）以及年龄、呼吸困难和气流阻塞（ADO）。

结果

CT Vratio与体重指数显著相关（r = -0.528，p < 0.001）。CT Vratio还与MMRC呼吸困难（r = 0.387，p = 0.001）、6MWD（r = -0.459，p < 0.001）和SGRQ（r = 0.369，p = 0.001）评分显著相关。最后，CT Vratio与BODE和ADO多维COPD严重程度指数显著相关（r = 0.605，p < 0.001；r = 0.411, p < 0.001）。