Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China.
Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu, China.
Respir Care. 2018 Nov;63(11):1399-1406. doi: 10.4187/respcare.06050.
Airway remodeling is a characteristic structural change that occurs extensively in the airways of patients with asthma. The change can be evaluated by measuring airway dimensions by using high-resolution computed tomography. This study aimed to explore the variation trends of airway dimensions from the second- to sixth-generation bronchi in subjects with asthma.
Sixty subjects with asthma and 40 healthy controls underwent high-resolution computed tomography. The right upper lobe apical segmental bronchus, right lower lobe posterior basal segmental bronchus, left upper lobe apicoposterior segmental bronchus, and the left lower lobe posterior basal segmental bronchus were identified on computed tomography images. The luminal area, wall area, and wall area percentage of each bronchus were measured from the second (lobar) to the sixth generation. The variation trends of these indices (luminal area, wall area, and wall area percentage) were then compared between the subjects with asthma and the healthy controls.
From the proximal to the distal airway, the luminal area and wall area decreased gradually, whereas the wall area percentage increased gradually in all the participants; the difference between the participants with asthma and the healthy controls in the luminal area, wall area, and wall area percentage increased gradually from the second (lobar) to the sixth generation; there was a significant difference between the participants with asthma and the healthy controls in the right lower lobe posterior basal segmental bronchus, left upper lobe apicoposterior segmental bronchus, and left lower lobe posterior basal segmental bronchus wall area percentage ( = .001, .01 and .001, respectively) but not in the right upper lobe apical segmental bronchus wall area percentage ( = .050).
Airway remodeling in asthma was more prominent in distal airways and at lower lobe bronchi.
气道重塑是哮喘患者气道广泛发生的特征性结构改变，可以通过高分辨率计算机断层扫描（HRCT）测量气道尺寸来评估。本研究旨在探讨哮喘患者从第 2 代至第 6 代支气管气道尺寸的变化趋势。
60 例哮喘患者和 40 例健康对照者接受 HRCT 检查。在 CT 图像上识别右肺上叶尖段支气管、右肺下叶后基底段支气管、左肺上叶尖后段支气管和左肺下叶后基底段支气管。测量各支气管从第 2 代（叶段）至第 6 代的管腔面积、管壁面积和管壁面积百分比。然后比较哮喘患者和健康对照组这些指标（管腔面积、管壁面积和管壁面积百分比）的变化趋势。
从近侧气道到远侧气道，所有参与者的管腔面积和管壁面积逐渐减小，而管壁面积百分比逐渐增加；哮喘患者与健康对照组在第 2 代（叶段）至第 6 代支气管的管腔面积、管壁面积和管壁面积百分比差异逐渐增大；哮喘患者与健康对照组在右肺下叶后基底段支气管、左肺上叶尖后段支气管和左肺下叶后基底段支气管的管壁面积百分比存在显著差异（分别为 P =.001、.01 和.001），而在右肺上叶尖段支气管的管壁面积百分比差异无统计学意义（P =.050）。
哮喘患者的气道重塑在远端气道和下叶支气管更为明显。
Zotero 插件