Hu Po-Wei, Chen Chun-Ku, Hsiao Yi-Han, Weng Ching-Yao, Lee Ying-Chi, Su Kang-Cheng, Feng Jia-Yih, Chou Kun-Ta, Perng Diahn-Warng, Ko Hsin-Kuo
Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Division of Chest Medicine, Department of Internal Medicine, National Yang-Ming Chiao Tung University Hospital, Yi-Lan, Taiwan, ROC.
Respirology. 2024 Nov;29(11):962-968. doi: 10.1111/resp.14811. Epub 2024 Aug 15.
Correlations between the image analysis of CT scan, lung function and quality of life in patients with idiopathic pulmonary fibrosis (IPF) remain unclear. This study aimed to investigate the impacts of pulmonary blood-vessel distribution and the extent of fibrosis on the lung function and quality of life of patients with IPF.
Patients were enrolled in an IPF registry and had completed pulmonary function tests, chest HRCT, St. George Respiratory Questionnaire (SGRQ) and echocardiography. Pulmonary blood-vessel distribution, specific image-derived airway volume (siVaw) and fibrosis extent (siVfib) were quantitatively calculated by functional respiratory imaging on HRCT.
The study subjects were categorized into DLco <40% pred. (n = 40) and DLco ≥40% pred. (n = 19) groups. Patients with DLco <40% pred. had significantly higher scores of SGRQ, composite physiologic index (CPI), exercise oxygen desaturation (∆SpO), siVaw, lower FVC% pred. and 6-minute walking distance% pred. The proportion of small blood vessels in the upper lobes (BV5PR-UL) was significantly correlated with CPI, DLco % Pred., FVC% pred., SGRQ and ∆SpO. Only BV5PR-UL had a significant impact on all indices but not BV5PR in the lower lobes (BV5PR-LL). siVfib was significantly negatively correlated with BV5PR-UL, DLco% pred. and FVC% pred., as well as positively correlated with CPI, ∆SpO and siVaw.
BV5PR-UL and siVfib had significant correlations with lung function and may become important indicators to assess the severity of IPF and the impact on quality of life.
特发性肺纤维化（IPF）患者的CT扫描图像分析、肺功能和生活质量之间的相关性尚不清楚。本研究旨在探讨肺血管分布和纤维化程度对IPF患者肺功能和生活质量的影响。
将患者纳入IPF登记系统，并完成肺功能测试、胸部HRCT、圣乔治呼吸问卷（SGRQ）和超声心动图检查。通过HRCT上的功能性呼吸成像定量计算肺血管分布、特定图像衍生气道容积（siVaw）和纤维化程度（siVfib）。
研究对象分为DLco<40%预计值组（n = 40）和DLco≥40%预计值组（n = 19）。DLco<40%预计值的患者SGRQ、综合生理指数（CPI）、运动性氧饱和度下降（∆SpO）、siVaw得分显著更高，FVC%预计值和6分钟步行距离%预计值更低。上叶小血管比例（BV5PR-UL）与CPI、DLco%预计值、FVC%预计值、SGRQ和∆SpO显著相关。只有BV5PR-UL对所有指标有显著影响，而下叶的BV5PR（BV5PR-LL）则没有。siVfib与BV5PR-UL、DLco%预计值和FVC%预计值显著负相关，与CPI、∆SpO和siVaw显著正相关。
BV5PR-UL和siVfib与肺功能显著相关，可能成为评估IPF严重程度及其对生活质量影响的重要指标。
