1 Department of Internal Medicine V, University of Munich (LMU), Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Munich, Germany.
2 Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Chron Respir Dis. 2019 Jan-Dec;16:1479972318775423. doi: 10.1177/1479972318775423. Epub 2018 May 9.
Phenotyping of chronic obstructive pulmonary disease (COPD) with computed tomography (CT) is used to distinguish between emphysema- and airway-dominated type. The phenotype is reflected in correlations with lung function measures. Among these, the relative value of body plethysmography has not been quantified. We addressed this question using CT scans retrospectively collected from clinical routine in a large COPD cohort. Three hundred and thirty five patients with baseline data of the German COPD cohort COPD and Systemic Consequences-Comorbidities Network were included. CT scans were primarily evaluated using a qualitative binary emphysema score. The binary score was positive for emphysema in 52.5% of patients, and there were significant differences between the positive/negative groups regarding forced expiratory volume in 1 second (FEV), FEV/forced vital capacity (FVC), intrathoracic gas volume (ITGV), residual volume (RV), specific airway resistance (sRaw), transfer coefficient (KCO), transfer factor for carbon monoxide (TLCO), age, pack-years, and body mass index (BMI). Stepwise discriminant analyses revealed the combination of FEV/FVC, RV, sRaw, and KCO to be significantly related to the binary emphysema score. The additional positive predictive value of body plethysmography, however, was only slightly higher than that of the conventional combination of spirometry and diffusing capacity, which if taken alone also achieved high predictive values, in contrast to body plethysmography. The additional information on the presence of CT-diagnosed emphysema as conferred by body plethysmography appeared to be minor compared to the well-known combination of spirometry and CO diffusing capacity.
使用计算机断层扫描（CT）对慢性阻塞性肺疾病（COPD）进行表型分析，用于区分肺气肿型和气道型。表型反映在与肺功能测量的相关性中。在这些相关性中，体描仪的相对价值尚未量化。我们使用从德国 COPD 队列 COPD 和系统后果-合并症网络的大型 COPD 队列的临床常规中回顾性收集的 CT 扫描来解决这个问题。共纳入 335 例基线数据完整的患者。CT 扫描主要使用定性二进制肺气肿评分进行评估。在 52.5%的患者中，二进制评分为阳性，阳性/阴性组之间在 1 秒用力呼气量（FEV）、FEV/用力肺活量（FVC）、胸腔内气体量（ITGV）、残气量（RV）、气道阻力（sRaw）、转移系数（KCO）、一氧化碳转移因子（TLCO）、年龄、包年数和体重指数（BMI）方面存在显著差异。逐步判别分析显示，FEV/FVC、RV、sRaw 和 KCO 的组合与二进制肺气肿评分显著相关。然而，体描仪的额外阳性预测值仅略高于常规肺量计和弥散能力的组合，而单独使用这两种方法也具有较高的预测值，这与体描仪相反。与众所周知的肺量计和 CO 弥散能力组合相比，体描仪提供的 CT 诊断肺气肿的存在信息似乎较小。
