Ji Yingying, Chen Leqing, Yang Jinrong, Yang Xiangying, Yang Fan
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Front Med (Lausanne). 2023 Dec 7;10:1280651. doi: 10.3389/fmed.2023.1280651. eCollection 2023.
Whether the airway is involved in the pathogenesis of interstitial lung abnormalities (ILA) is not well understood. Also the impact of ILA on lung function in COPD patients remains controversial. We aimed to assess the quantitative CT measurements of airway wall thickness (AWT) and lung function according to ILA status in COPD patients.
157 COPD patients discharged from our hospital from August 1, 2019 through August 31, 2022 who underwent chest CT imagings and pulmonary function tests were retrospectively enrolled. Linear regression analysis and multiple models were used to analyze associations between quantitative assessment of airway wall changes and the presence of ILA.
In 157 COPD patients, 23 patients (14.6%) had equivocal ILA, 42 patients (26.8%) had definite ILA. The definite ILA group had the highest measurements of Pi10 (square root of theoretical airway wall area with a lumen perimeter of 10 mm), segmental AWT and segmental WA% (percentage of wall area), whereas the no ILA group had the lowest measurements of Pi10, segmental AWT and segmental WA%. In the adjusted analyses (adjusted by age, sex, body mass index, smoking intensity, COPD GOLD stage, lung function, slice thickness and scanner type), compared to COPD patients without ILA, the measurements of Pi10, segmental AWT and segmental WA% were higher in definite ILA group with differences of 0.225 mm ( = 0.012), 0.152 mm ( < 0.001), 4.8% ( < 0.001) respectively. COPD patients with definite ILA tended to have higher FEV1% predicted, FVC% predicted and lower MMEF% predicted, but there were no statistically differences among the three groups.
Our study demonstrates the higher AWT measures in COPD patients with ILA compared to the patients without ILA. These findings suggest that the airway may be involved in the pathogenesis of ILA.
气道是否参与间质性肺异常（ILA）的发病机制尚不清楚。此外，ILA对慢性阻塞性肺疾病（COPD）患者肺功能的影响仍存在争议。我们旨在根据COPD患者的ILA状态评估气道壁厚度（AWT）的定量CT测量值和肺功能。
回顾性纳入2019年8月1日至2022年8月31日期间从我院出院的157例接受胸部CT成像和肺功能测试的COPD患者。采用线性回归分析和多个模型分析气道壁变化的定量评估与ILA存在之间的关联。
在157例COPD患者中，23例（14.6%）有可疑ILA，42例（26.8%）有明确ILA。明确ILA组的Pi10（管腔周长为10 mm时理论气道壁面积的平方根）、节段性AWT和节段性WA%（壁面积百分比）测量值最高，而无ILA组的Pi10、节段性AWT和节段性WA%测量值最低。在调整分析中（根据年龄、性别、体重指数、吸烟强度、COPD全球倡议[GOLD]分期、肺功能、层厚和扫描仪类型进行调整），与无ILA的COPD患者相比，明确ILA组的Pi10、节段性AWT和节段性WA%测量值更高，差异分别为0.225 mm（P = 0.012）、0.152 mm（P < 0.001）、4.8%（P < 0.001）。有明确ILA的COPD患者预测的第一秒用力呼气容积（FEV1）%、预测的用力肺活量（FVC）%往往较高，预测的最大呼气中期流速（MMEF）%较低，但三组之间无统计学差异。
我们的研究表明，与无ILA的患者相比，有ILA的COPD患者的AWT测量值更高。这些发现表明气道可能参与ILA的发病机制。
