Mineshita Masamichi, Kida Hirotaka, Handa Hiroshi, Nishine Hiroki, Furuya Naoki, Inoue Takeo, Matsuoka Shin, Miyazawa Teruomi
Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Respiration. 2016;92(4):252-257. doi: 10.1159/000449255. Epub 2016 Sep 15.
Regional lung sound distribution in chronic obstructive pulmonary disease (COPD) is reported to be asynchronous. Mathematical analyses using vibration response imaging (VRI), such as left and right lung asynchrony (gap index; GI) and regional lung asynchrony (asynchrony score; AS), are useful measures to evaluate lung sound asynchrony.
The aim of this study was to investigate the association of lung sound asynchrony with pulmonary functions and emphysematous lesions in COPD patients.
VRI recordings and pulmonary function tests were performed in 46 stable male COPD patients and in 40 healthy male smokers. Lung sound asynchrony was evaluated using GI, AS of the left and right lung (AS L-R), and AS of the upper and lower lung (AS U-L). In 38 patients, computed tomography taken within 6 months was available and analyzed.
AS L-R and AS U-L were significantly higher in COPD patients than in healthy smokers, with no significant difference in GI. There were no significant correlations with either AS and pulmonary functions, excluding a negative correlation between AS U-L and diffusion capacity. Although there were no significant correlations between both AS and severity of emphysema, significant positive correlations were observed between heterogeneity of emphysematous lesions and AS L-R (ρ = 0.38, p < 0.05) or AS U-L (ρ = 0.51, p < 0.005).
Regional lung sounds are distributed more asynchronously in COPD patients than in healthy smokers, which correlates with the heterogeneous distribution of emphysematous lesions.
据报道，慢性阻塞性肺疾病（COPD）患者的肺部声音区域分布是不同步的。使用振动反应成像（VRI）进行的数学分析，如左右肺不同步（间隙指数；GI）和区域肺不同步（不同步评分；AS），是评估肺部声音不同步的有用指标。
本研究旨在探讨COPD患者肺部声音不同步与肺功能和肺气肿病变之间的关联。
对46例稳定期男性COPD患者和40例健康男性吸烟者进行了VRI记录和肺功能测试。使用GI、左右肺的AS（AS L-R）和上下肺的AS（AS U-L）评估肺部声音不同步。38例患者有6个月内的计算机断层扫描图像可供分析。
COPD患者的AS L-R和AS U-L显著高于健康吸烟者，GI无显著差异。除了AS U-L与弥散能力之间存在负相关外，AS与肺功能均无显著相关性。虽然AS与肺气肿严重程度均无显著相关性，但在肺气肿病变的异质性与AS L-R（ρ = 0.38，p < 0.05）或AS U-L（ρ = 0.51，p < 0.005）之间观察到显著的正相关。
与健康吸烟者相比，COPD患者的区域肺部声音分布更不同步，这与肺气肿病变的异质性分布相关。
