定量CT参数评价COPD疾病严重 程度的研究

目的 探讨定量CT参数评价慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）严重程度的价值。方法 选取2019年2月至2021年2月于温岭市中医院就诊并确诊为COPD的患者205例，所有患者均进行CT扫描及肺功能检查，比较不同分期患者的管腔面积（lumen area，LA）、管壁面积百分比（percentage of wall area，WA%）、管壁厚度与体表面积比值（ratio of tube wall thickness to body surface area，T/BSA）、管壁厚度与直径比值（thickness to diameter ratio，TDR）、肺叶低衰减区占整个肺体积的百分比（percentage of total lung area occupied by low attenuation area，LAA%）、肺气肿指数（emphysema index，EI）、空气潴留指数（air retention index，ATI）、第一秒用力呼气容积占预计值百分比（forced expiratory volume in one second as a percentage of predicted value，FEV1%）、FEV1/用力肺活量（forced vital capacity，FVC）情况，并进行相关性分析。结果 随着COPD严重程度的增加，体质量指数、FEV1%、FEV1/FVC、LA均逐渐降低（P<0.05），WA%、T/BSA、TDR、LAA%、EI、ATI均逐渐增加（P<0.05）；Pearson相关性分析结果显示，FEV1%与WA%、TDR均呈负相关（P<0.05），FEV1/FVC与WA%、TDR均呈正相关（P<0.05），FEV1%、FEV1/FVC与LAA%、EI、ATI均呈负相关（P<0.05）。结论 肺实质衰减参数、气道参数可作为COPD严重程度的预测因子，评价疾病进展。

Study of quantitative CT parameters in evaluating the severity of COPD

Objective To explore the value of quantitative CT parameters in evaluating the severity of chronic obstructive pulmonary disease (COPD). Methods From February 2019 to February 2021, 205 patients diagnosed as COPD were selected from Wenling Hospital of Traditional Chinese Medicine. All patients underwent CT scanning and lung function examination. The lumen area (LA), percentage of wall area (WA%), ratio of tube wall thickness to body surface area (T/BSA), thickness to diameter ratio (TDR), percentage of total lung area occupied by low attenuation area (LAA%), emphysema index (EI), air retention index (ATI), forced expiratory volume in one second as a percentage of predicted value (FEV1%) and FEV1/ forced vital capacity (FVC) in patients with different stages were compared and the correlation was analyzed. Results With the increase of COPD severity, body mass index, FEV1%, FEV1/FVC and LA decreased gradually (P<0.05), while WA%, T/BSA, TDR, LAA%, EI and ATI increased gradually (P<0.05). Pearson correlation analysis showed that FEV1% was negatively correlated with WA% and TDR (P<0.05), FEV1/FVC was positively correlated with WA% and TDR (P<0.05), and FEV1% and FEV1/FVC were negatively correlated with LAA%, EI and ATI (P<0.05). Conclusion Parenchymal attenuation parameters and airway parameters can be used as predictors of COPD severity to evaluate disease progression.