慢性阻塞性肺疾病患者CT表型分类与肺功能检查的相关性分析

目的 探讨不同慢性阻塞性肺疾病(COPD)CT表型CT特征与肺功能检查(PFT)指标的相关性。方法 回顾性分析72例COPD患者CT和临床资料,其按CT特点将其分为A型、E型和M型,CT图像中检测肺气肿区域体素容积占全肺容积的百分比,即像素指数(PI_-950),比较不同分型COPD患者PI_-950差异,并分析PI_-950与PFT指标,包括1秒钟用力呼气容积(FEV₁)实测值占预计值百分比、FEV₁/用力肺活量(FVC)和残气量(RV)/肺总量(TLC)的相关性。结果 A型32例、E型19例、M型21例,其PI_-950分别为5.17%(1.63%,7.97%)、26.70%(19.79%,44.13%)和23.20%(15.24%,32.49%),A型低于其他两型(P均<0.05)。A型和E型患者PI_-950均与FEV₁实测值占预计值百分比和FEV₁/FVC呈负相关、与RV/TLC正相关(P均<0.05),M型患者PI_-950与FEV₁实测值占预计值百分比、FEV₁/FVC、RV/TLC均无相关性(P均>0.05)。结论 通过CT特征对COPD进行分类可为COPD患者的个性化治疗提供一定的帮助。

Correlation between CT features and pulmonary function test in different CT phenotypes of chronic obstructive pulmonary disease

Objective To explore the correlation CT features and pulmonary function test (PFT) in different CT phenotypes of chronic obstructive pulmonary disease (COPD). Methods CT and clinical data of 72 patients with COPD were retrospectively analyzed. The patients were classified into A, E and M phenotype according to the findings of CT. The percentage of emphysema lesion voxel volume for the total lung volume that was pixel index (PI_-950) was measured and compared among different COPD phenotypes, the correlation between PI_-950 and PFT indexes including percentage of measured value for predicted value of forced expiratory volume at 1 second (FEV₁), FEV₁/forced vital capacity(FVC) and residual volume (RV) /total lung capacity (TLC) were analyzed in each of three phenotypes. Results There were 32 of A, 19 of E and 21 of M phenotype. PI_-950 in A phenotype 5.17% (1.63%, 7.97%) was statistical lower than that in E phenotype 26.70% (19.79%, 44.13%) and M phenotype 23.20% (15.24%, 32.49%, both P<0.05). In the A and E phenotype, PI_-950 were negatively correlated with percentage of measured value for predicted value of FEV₁ and FEV₁/FVC, and positively correlated with RV/TLC (all P<0.05). There were no correlations between PI_-950 and percentage of measured value for predicted value of FEV₁, FEV₁/FVC, RV/TLC in M phenotype (all P>0.05). Conclusion The phenotypes according to the findings of CT is helpful for the individualized treatment of COPD.