Wang Yan, Chai Limin, Chen Yuqian, Liu Jin, Wang Qingting, Zhang Qianqian, Qiu Yuanjie, Li Danyang, Chen Huan, Shen Nirui, Shi Xiangyu, Wang Jian, Xie Xinming, Li Manxiang
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Surg. 2023 Jan 4;9:1066031. doi: 10.3389/fsurg.2022.1066031. eCollection 2022.
This study aimed to analyze the correlation between quantitative computed tomography (CT) parameters and airflow obstruction in patients with COPD.
PubMed, Embase, Cochrane and Web of Knowledge were searched by two investigators from inception to July 2022, using a combination of pertinent items to discover articles that investigated the relationship between CT measurements and lung function parameters in patients with COPD. Five reviewers independently extracted data, and evaluated it for quality and bias. The correlation coefficient was calculated, and heterogeneity was explored. The following CT measurements were extracted: percentage of lung attenuation area <-950 Hounsfield Units (HU), mean lung density, percentage of airway wall area, air trapping index, and airway wall thickness. Two airflow obstruction parameters were extracted: forced expiratory volume in the first second as a percentage of prediction (FEV%pred) and FEV divided by forced expiratory volume lung capacity.
A total of 141 studies (25,214 participants) were identified, which 64 (6,341 participants) were suitable for our meta-analysis. Results from our analysis demonstrated that there was a significant correlation between quantitative CT parameters and lung function. The absolute pooled correlation coefficients ranged from 0.26 (95% CI, 0.18 to 0.33) to 0.70 (95% CI, 0.65 to 0.75) for inspiratory CT and 0.56 (95% CI, 0.51 to 0.60) to 0.74 (95% CI, 0.68 to 0.80) for expiratory CT.
Results from this analysis demonstrated that quantitative CT parameters are significantly correlated with lung function in patients with COPD. With recent advances in chest CT, we can evaluate morphological features in the lungs that cannot be obtained by other clinical indices, such as pulmonary function tests. Therefore, CT can provide a quantitative method to advance the development and testing of new interventions and therapies for patients with COPD.
本研究旨在分析慢性阻塞性肺疾病（COPD）患者定量计算机断层扫描（CT）参数与气流阻塞之间的相关性。
两名研究人员从数据库建库至2022年7月对PubMed、Embase、Cochrane和Web of Knowledge进行检索，使用相关检索词组合来查找研究COPD患者CT测量值与肺功能参数之间关系的文章。五名评审员独立提取数据，并对其质量和偏倚进行评估。计算相关系数，并探讨异质性。提取以下CT测量值：肺衰减面积<-950亨氏单位（HU）的百分比、平均肺密度、气道壁面积百分比、气体潴留指数和气道壁厚度。提取两个气流阻塞参数：第一秒用力呼气容积占预计值的百分比（FEV%pred）以及FEV除以用力呼气肺活量。
共识别出141项研究（25214名参与者），其中64项研究（6341名参与者）适合纳入我们的荟萃分析。我们的分析结果表明，定量CT参数与肺功能之间存在显著相关性。吸气CT的绝对合并相关系数范围为0.26（95%CI，0.18至0.33）至0.70（95%CI，0.65至0.75），呼气CT的绝对合并相关系数范围为0.56（95%CI，0.51至0.60）至0.74（95%CI，0.68至0.80）。
该分析结果表明，COPD患者的定量CT参数与肺功能显著相关。随着胸部CT的最新进展，我们可以评估肺部的形态学特征，而这些特征是其他临床指标（如肺功能测试）无法获得的。因此，CT可以提供一种定量方法，以推动COPD患者新干预措施和治疗方法的开发与测试。
