Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Department of Respiratory Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Brain Behav. 2018 Aug;8(8):e01065. doi: 10.1002/brb3.1065. Epub 2018 Jul 13.
The aim of this study was to explore whether patients with chronic obstructive pulmonary disease (COPD) develop vasogenic cerebral edema, and whether this edema contributes to the COPD-related disability.
Eighteen stable patients with COPD and 17 matched healthy volunteers were enrolled. Apparent diffusion coefficient (ADC) values were calculated by voxel-based analysis using DTI-Studio software based on diffusion tensor imaging. COPD-related disability was calculated using activities of daily living (ADL) scale.
In patients with COPD, ADC increased in the white matter fiber tracts including the bilateral anterior cingulum and posterior corpus callosum and in the white matter fibers connecting the bilateral insular cortices, sub-lobar cortices, and pars triangularis cortices and the left rectus and olfactory gyrus. However, after further controlling for cigarette smoking, the difference in ADC values in the posterior corpus callosum between groups disappeared. Patients with COPD had significantly higher scores in ADL than that in controls. Moreover, ADL scores were positively correlated with the increased regional ADC values.
Vasogenic cerebral edema occurs in patients with COPD. Cigarette smoking may be a risk factor for COPD-related vasogenic edema. Vasogenic cerebral edema may be related to the COPD-related ADL impairment.
本研究旨在探讨慢性阻塞性肺疾病（COPD）患者是否会发生血管源性脑水肿，以及这种脑水肿是否导致 COPD 相关残疾。
纳入 18 例稳定期 COPD 患者和 17 名匹配的健康志愿者。使用 DTI-Studio 软件基于弥散张量成像进行基于体素的分析，计算表观弥散系数（ADC）值。采用日常生活活动（ADL）量表评估 COPD 相关残疾。
在 COPD 患者中，双侧前扣带回和后胼胝体的白质纤维束以及双侧岛叶皮质、小叶皮质和三角部皮质与左侧直回和嗅叶的白质纤维中的 ADC 值增加。然而，进一步控制吸烟后，两组间后胼胝体 ADC 值的差异消失。COPD 患者的 ADL 评分明显高于对照组。此外，ADL 评分与区域性 ADC 值的增加呈正相关。
COPD 患者存在血管源性脑水肿。吸烟可能是 COPD 相关血管源性脑水肿的危险因素。血管源性脑水肿可能与 COPD 相关的 ADL 损害有关。
