Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong, People's Republic of China.
Respiratory Disease Key Laboratory of Qingdao, Qingdao Municipal Hospital, Qingdao, Shandong, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2021 Mar 2;16:535-544. doi: 10.2147/COPD.S295320. eCollection 2021.
To explore a practical marker for quantitatively analyzing the small airway remodeling in COPD by HRCT.
Twenty-four patients with COPD (GOLD I, n = 7; GOLD II, n = 8; GOLD III+IV, n = 9) and 14 healthy controls (7 normal pulmonary function; 7 small-airway disease (SAD)) were enrolled in the study as five groups, GOLD I, GOLD II, GOLD III+IV, normal and SAD. All subjects underwent HRCT and spirometry. With ISP 9.0, whole emphysema index (EI) and the airway parameters, including wall area (WA), lumen area (LA), airway area (AA) of the 3rd, 5th and 9th generations of bronchi, were measured successively. The ratio of LA/AA and WA/AA in the 3rd, 5th and 9th generations of bronchi were calculated and compared among groups.
For the five groups, EI was increased only in GOLD III+IV group ( < 0.05), while the ratio of LA/AA (9-LA/AA) and WA/AA (9-WA/AA) in 9th generation of bronchi have significantly changed since SAD group ( < 0.05). There were significant correlation between FEVgenerations of bronchi (r3 = 0.429, r5 = 0.583, r9 = 0.592, respectively, < 0.05); FEV% and WA/AA (r3 = -0.428, r5 = -0.532, r9 = -0.570, respectively, < 0.05); as well as MMEF% and LA/AA (r3 = 0.421, r5 = 0.566, r9 = 0.610, respectively, < 0.05); MMEF% and WA/AA (r3 = -0.421, r5 = -0.529, r9 = -0.593, respectively, < 0.05).
Small airway remodeling has occurred in the early stage of COPD, while emphysema in the late stage of COPD. The 9-LA/AA and 9-WA/AA are accurate and practical markers for small airway remodeling of COPD.
通过高分辨率 CT（HRCT）探索一种定量分析 COPD 小气道重塑的实用标志物。
本研究纳入了 24 例 COPD 患者（GOLD I 期，n=7；GOLD II 期，n=8；GOLD III+IV 期，n=9）和 14 例健康对照者（7 例为正常肺功能；7 例为小气道疾病（SAD）），共分为 5 组，分别为 GOLD I 期、GOLD II 期、GOLD III+IV 期、正常组和 SAD 组。所有受试者均接受 HRCT 和肺功能检查。使用 ISP 9.0，依次测量全肺气肿指数（EI）和气道参数，包括第 3、5 和 9 代支气管的壁面积（WA）、管腔面积（LA）和气道面积（AA）。计算并比较各组第 3、5 和 9 代支气管的 LA/AA 和 WA/AA 比值。
对于 5 组患者，仅在 GOLD III+IV 组中 EI 增加（<0.05），而 SAD 组之后第 9 代支气管的 LA/AA（9-LA/AA）和 WA/AA（9-WA/AA）比值发生显著变化（<0.05）。第 3、5 和 9 代支气管的 FEV 之间存在显著相关性（r3=0.429、r5=0.583、r9=0.592，均<0.05）；FEV%与 WA/AA（r3=-0.428、r5=-0.532、r9=-0.570，均<0.05）；以及 MMEF%与 LA/AA（r3=0.421、r5=0.566、r9=0.610，均<0.05）；以及 MMEF%与 WA/AA（r3=-0.421、r5=-0.529、r9=-0.593，均<0.05）。
COPD 的早期阶段已经发生了小气道重塑，而晚期则发生了肺气肿。9-LA/AA 和 9-WA/AA 是 COPD 小气道重塑的准确实用标志物。
