EBUS对慢性阻塞性肺疾病气道重构的研究

目的 探讨气道内超声(EBUS)在慢性阻塞性肺疾病(COPD)患者气道重构中的应用价值.方法 26例COPD患者,22例健康对照,选择右中叶为目标气道.经电子支气管镜工作通道插入超声探头,并在其引导下到达目标支气管.结果 COPD患者右中叶管壁厚度、管壁面积以及黏膜层、黏膜下层厚度与对照组比较有显著差异;而两组软骨层的厚度无显著差异.结论 COPD患者右中叶存在气道壁增厚,管壁面积增大.气道重构主要发生在黏膜层及黏膜下层.EBUS可以成为研究COPD患者气道重构的新方法.

The use of endobronchial ultrasound in assessment of bronchial wall remodeling in patients with COPD

Objective The aim of the study is to explore the value of EBUS in the assessment of bronchial wall remodeling in patients with COPD.Methods In 26 patients with COPD and 22 healthy subjects,EBUS was used to measure bronchial wall thickness in the middle segment of the right lung.With a radial 20-MHz probe,EBUS identified the 5-laminar structure of the bronchial wall.Layer 1(L1) and layer 2(L2) were analyzed separately,and layers 3 to 5(L3-5),which corresponded to cartilage,were analyzed jointly.Digitalized EBUS images were used for the quantitative assessment of bronchial wall thickness.Results The thickness and area of the bronchial wall were significantly greater in patients with COPD than those in the control subjects.The thickness of L1 and L2 were significantly greater in patients with COPD separately than those in the control subjects,but L3-5 were the same in the two groupe.Conclusion Airway remodeling exists in the patients with COPD.Endobronchial ultrasound(EBUS) is a new technique that can assess the bronchial wall layers.