Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, Sichuan, China.
Department of Laboratory Medicine, Mianyang People's Hospital, Mianyang, Sichuan, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e40291. doi: 10.1097/MD.0000000000040291.
This research aims to explore the diagnostic value of computed tomography (CT) indicators in patients with stable chronic obstructive pulmonary disease (COPD) in a plateau of China, and to find out the correlation between CT indexes and lung function and symptoms. This study screened out 53 stable COPD patients and 53 healthy people through inclusion and exclusion criteria in Hongyuan county, Aba Prefecture, Sichuan Province, between July 2020 and December 2020, and then collected their baseline data, conducted lung function tests and chest CT scans, and collected COPD Assessment Test (CAT), modified Medical Research Council Dyspnea Scale (mMRC) scores. The CT indexes of the 2 groups were compared, binary logistic regression was used to analyze the influence of COPD, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the CT indexes for COPD. The Spearman test was used to understand the correlation analysis between the CT indexes and lung function, symptom score, and the number of acute exacerbations. Multiple linear regression was used to analyze the influencing factors of lung function. The percentage of low-attenuation areas less than -950 Hounsfield units (%LAA-950; t = -4.387,P = 0), percentage of wall area (WA%; t = -4.501, P = 0), and thickness-diameter ratio (TDR; t = -4.779, P = 0) in the COPD group were higher than those in the normal group. ROC shows that: %LAA-950 (P = .047) and TDR (P = .034) were independent influence in COPD in the plateau. %LAA-950 combined with TDR (AUC = 0.757, P < .001) had the value of diagnosis of COPD in the plateau. All 3 indexes are negatively correlated with lung function, and positively correlated with the symptoms and the number of acute exacerbations. Multiple linear regression analysis showed that the main factors for decrease of ratio of measurement to prediction of forced expiratory volume to the first second (FEV1%) included %LAA-950 (OR = -0.449, P < .001) and WA% (OR = -0.516, P < .001). CT indexes have a certain diagnostic value in patients with stable COPD at high altitude.
本研究旨在探讨中国高原地区稳定期慢性阻塞性肺疾病（COPD）患者的计算机断层扫描（CT）指标的诊断价值，并找出 CT 指标与肺功能和症状的相关性。本研究通过纳入和排除标准，于 2020 年 7 月至 2020 年 12 月在四川省阿坝州红原县筛选出 53 例稳定期 COPD 患者和 53 例健康人，收集其基线资料，进行肺功能检查和胸部 CT 扫描，并收集 COPD 评估测试（CAT）、改良医学研究委员会呼吸困难量表（mMRC）评分。比较两组 CT 指标，采用二项逻辑回归分析 COPD 的影响，采用受试者工作特征（ROC）曲线评价 CT 指标对 COPD 的诊断价值。采用斯皮尔曼检验了解 CT 指标与肺功能、症状评分和急性加重次数的相关性分析。采用多元线性回归分析肺功能的影响因素。COPD 组的低衰减区百分比小于-950 个豪斯菲尔德单位（%LAA-950；t=-4.387，P=0）、壁区百分比（WA%；t=-4.501，P=0）和厚度直径比（TDR；t=-4.779，P=0）高于正常组。ROC 显示：%LAA-950（P=0.047）和 TDR（P=0.034）是高原地区 COPD 的独立影响因素。%LAA-950 与 TDR 联合（AUC=0.757，P<0.001）对高原地区 COPD 有诊断价值。所有 3 个指标均与肺功能呈负相关，与症状和急性加重次数呈正相关。多元线性回归分析显示，用力呼气量第一秒百分比测量值与预测值之比（FEV1%）下降的主要因素包括%LAA-950（OR=-0.449，P<0.001）和 WA%（OR=-0.516，P<0.001）。CT 指标对高原地区稳定期 COPD 患者具有一定的诊断价值。
