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基于HRCT的煤矿工人尘肺气道定量参数与疾病严重程度的相关性

[Correlation between quantitative airway parameters and disease severity of coal workers' pneumoconiosis based on HRCT].

作者信息

Zhou J X, Zhao S H, Wang Y F, Xuan J, Lu H Q, Zhu L

机构信息

Department of Radiology, General Hospital of Ningxia Medical University; First Clinical College of Medicine, Ningxia Medical University, Yinchuan 750000, China.

Department of Respiratory, The Fifth People's Hospital of Ningxia, Shizuishan 753000, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2025 Apr 20;43(4):247-253. doi: 10.3760/cma.j.cn121094-20240723-00340.

Abstract

To observe the changes of small airway parameters in patients with coal workers' pneumoconiosis in different disease stages by high resolution computed tomography (HRCT) , and analyze the correlation between them and the severity of the disease. From June 2016 to June 2023, 25 healthy volunteers and 71 untreated patients with coal worker's pneumoconiosis in the Fifth People's Hospital of Ningxia were selected as the research objects. The clinical and imaging data of the patients were collected, and the disease stages were performed according to the dust exposure history and high-kilovolt chest X-ray. The patients were divided into 4 groups: control group (25 cases) , coal workers' pneumoconiosis stage Ⅰ group (17 cases) , coal workers' pneumoconiosis stage Ⅱ group (32 cases) and coal workers' pneumoconiosis stage Ⅲ group (22 cases) . Quantitative chest HRCT parameters of each group were collected, including the square root of wall area at 10 mm inner perimeter (AWT-Pi10, Pi10) , airway wall thickness, airway wall volume, airway wall area percentage of the whole lung and the 5th, 6th, 7th and 8th level airways, and low attenuation area percentage (LAA%) of the whole lung. Pulmonary function indicators were collected, including forced expiratory volume in 1 second (FEV(1)) and the percentage of its projected value [FEV(1) (%pred) ], the ratio of FEV(1) to forced vital capacity (FEV(1)/FVC) and the percentage of its projected value[FEV(1)/FVC (%pred) ]. One-way ANOVA or Kruskal-Wallis test and Spearman rank correlation were used to analyze the difference and correlation. Compared with control group, FEV(1), FEV(1) (%pred) , FEV(1)/FVC and FEV(1)/FVC (%pred) in stage Ⅱ and Ⅲ coal workers' pneumoconiosis groups were lower (<0.05) . In addition, the FEV(1) and FEV(1) (%pred) of the stage Ⅲgroup were lower than those of the stageⅡ group (<0.05) , and the FEV(1)/FVC and FEV(1)/FVC (%pred) of the stage Ⅲgroup were lower than those of the stage Ⅰgroup (<0.05) . Compared with stage Ⅰ group, Pi10 in stage Ⅲ group were increased ( < 0.05) at the 6th and 8th level airways, and airway wall thickness and airway wall volume in the 6th, 7th and 8th level airways of stage Ⅲgroup increased (<0.05) . Correlation analysis showed that all pulmonary function indexes were negatively correlated with Pi10 of whole lung and the 6th, 7th and 8th level airways (<0.05) , all pulmonary function indexes were negatively correlated with airway wall thickness of the 7th and 8th level airways (<0.05) , and FEV(1)/FVC (%pred) was negatively correlated with airway wall volume of the 7th and 8th level airways (<0.05) . FEV(1), FEV(1) (%pred) , FEV(1)/FVC (%pred) were negatively correlated with percentage of airway wall area of whole lung and the 6th, 7th and 8th level airways (<0.05) . The quantitative airway parameters of coal workers' pneumoconiosis based on HRCT are correlated with pulmonary function indexes, which can reflect the severity of coal workers' pneumoconiosis.

摘要

通过高分辨率计算机断层扫描(HRCT)观察不同疾病阶段煤工尘肺患者小气道参数的变化,并分析其与疾病严重程度之间的相关性。选取2016年6月至2023年6月在宁夏第五人民医院的25名健康志愿者和71例未经治疗的煤工尘肺患者作为研究对象。收集患者的临床和影像资料,并根据粉尘接触史和高千伏胸部X线进行疾病分期。将患者分为4组:对照组(25例)、煤工尘肺Ⅰ期组(17例)、煤工尘肺Ⅱ期组(32例)和煤工尘肺Ⅲ期组(22例)。收集每组的胸部HRCT定量参数,包括10mm内周长处的壁面积平方根(AWT-Pi10,Pi10)、气道壁厚度、气道壁容积、全肺及第5、6、7、8级气道的气道壁面积百分比,以及全肺的低衰减面积百分比(LAA%)。收集肺功能指标,包括第1秒用力呼气容积(FEV(1))及其预计值百分比[FEV(1) (%pred)]、FEV(1)与用力肺活量的比值(FEV(1)/FVC)及其预计值百分比[FEV(1)/FVC (%pred)]。采用单因素方差分析或Kruskal-Wallis检验以及Spearman秩相关分析差异和相关性。与对照组相比,煤工尘肺Ⅱ期和Ⅲ期组的FEV(1)、FEV(1) (%pred)、FEV(1)/FVC和FEV(1)/FVC (%pred)较低(<0.05)。此外,Ⅲ期组的FEV(1)和FEV(1) (%pred)低于Ⅱ期组(<0.05),Ⅲ期组的FEV(1)/FVC和FEV(1)/FVC (%pred)低于Ⅰ期组(<0.05)。与Ⅰ期组相比,Ⅲ期组第6和第8级气道的Pi10增加(<0.05),Ⅲ期组第6、7和第8级气道的气道壁厚度和气道壁容积增加(<0.05)。相关性分析表明,所有肺功能指标与全肺及第6、7和第8级气道的Pi10呈负相关(<0.05),所有肺功能指标与第7和第8级气道的气道壁厚度呈负相关(<0.05),FEV(1)/FVC (%pred)与第7和第8级气道的气道壁容积呈负相关(<0.05)。FEV(1)、FEV(1) (%pred)、FEV(1)/FVC (%pred)与全肺及第6、7和第8级气道的气道壁面积百分比呈负相关(<0.05)。基于HRCT的煤工尘肺气道定量参数与肺功能指标相关,可反映煤工尘肺的严重程度。

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