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慢性阻塞性肺疾病患者肺功能测试参数与肺气肿定量计算机断层扫描测量值之间的关系。

Relationships between pulmonary function test parameters and quantitative computed tomography measurements of emphysema in subjects with chronic obstructive pulmonary disease.

作者信息

Šileikienė Virginija, Urbonas Marius, Matačiūnas Mindaugas, Norkūnienė Jolita

机构信息

Centre of Pulmonology and Allergology of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.

Clinic of Infectious and Chest Diseases, Dermatovenerology and Allergology of Vilnius University, Vilnius, Lithuania.

出版信息

Acta Med Litu. 2017;24(4):209-218. doi: 10.6001/actamedica.v24i4.3616.

Abstract

OBJECTIVE

CT is able to precisely define the pathological process in COPD. There are a number of previous articles discussing the distribution of emphysema and its connection with pulmonary function tests. However, the results obtained by the researchers are not identical.

PURPOSE

To assess relationships between emphysema and pulmonary function test parameters in COPD patients.

MATERIALS AND METHODS

Fifty-nine patients diagnosed to have COPD underwent chest CT examinations and pulmonary function tests.For the quantitative assessment, percentages of low attenuation volume LAV (%) of a both lungs, the right lung, the left lung, and each lobe were obtained. Quantitative CT measurements were compared with forced expiratory volume in 1 s (FEV), the ratio of FEV to forced vital capacity (FEV/FVC), the diffusing capacity for carbon monoxide (Lco) and total lung capacity (TLC).

RESULTS

Except for the right middle lobe and the right upper lobe, respectively, all the quantitative CT measurements showed weak to moderate negative correlations with diffusing capacity (Lco) ( = -0.35 to -0.61, < 0.05) and weak positive correlations with TLC ( = 0.34 to 0.44, < 0.05). Group analysis indicated that LAV (%) values of both lungs, right lung, left lung, and each lobe, except for right middle lobe, were increased in patients with GOLD stages 3 and 4 of COPD compared to GOLD stages 1 and 2 ( < 0.05).

CONCLUSION

CT measurements of emphysema are significantly related to pulmonary function tests results, particularly Lco.

摘要

目的

CT能够精确界定慢性阻塞性肺疾病(COPD)中的病理过程。此前有许多文章讨论了肺气肿的分布及其与肺功能测试的关联。然而,研究人员所获得的结果并不相同。

目的

评估COPD患者中肺气肿与肺功能测试参数之间的关系。

材料与方法

59例被诊断为COPD的患者接受了胸部CT检查和肺功能测试。为进行定量评估,获取了双肺、右肺、左肺及各肺叶的低衰减容积百分比(LAV(%))。将定量CT测量结果与第1秒用力呼气量(FEV)、FEV与用力肺活量的比值(FEV/FVC)、一氧化碳弥散量(Lco)和肺总量(TLC)进行比较。

结果

除右中叶和右上叶外,所有定量CT测量结果均显示与弥散量(Lco)呈弱至中度负相关(r = -0.35至-0.61,P < 0.05),与TLC呈弱正相关(r = 0.34至0.44,P < 0.05)。分组分析表明,与慢性阻塞性肺疾病全球倡议(GOLD)1期和2期患者相比,GOLD 3期和4期COPD患者的双肺、右肺、左肺及除右中叶外各肺叶的LAV(%)值均升高(P < 0.05)。

结论

肺气肿的CT测量结果与肺功能测试结果显著相关,尤其是与Lco相关。

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