慢性阻塞性肺疾病患者与肺功能正常吸烟者CT肺实质灌注成像对照

目的 分析慢性阻塞性肺疾病（COPD）患者及肺功能正常吸烟者CT肺实质灌注图像的差异。方法 对63例COPD患者及20名肺功能正常吸烟者（对照组）行肺CTPI，将COPD患者分为轻度亚组（16例）、中度亚组（18例）、重度亚组（11例）和极重度亚组（18例），在肺叶水平计算灌注缺损区与正常区CT值比值（R_HU），比较各组体质量指数（BMI）、吸烟量及各肺叶R_HU的差异。结果 对照组BMI与重度、极重度COPD亚组比较，对照组吸烟量与极重度COPD亚组比较差异均有统计学意义（P=0.006、0.002、0.007）。同组各肺叶R_HU差异均无统计学意义（P均>0.05）。对照组右肺下叶R_HU与重度、极重度COPD亚组差异有统计学意义（P=0.03、0.02），其他各肺叶R_HU各组差异均无统计学意义（P均>0.05）。对照组与各COPD亚组R_HU差异均有统计学意义（P均<0.05）；轻度与重度、与极重度COPD亚组，中度与极重度COPD亚组R_HU差异均有统计学意义（P=0.022、0.001、0.003）。结论 R_HU可区分COPD和肺功能正常吸烟者，有可能成为评估COPD严重程度的指标之一。

Comparison on pulmonary perfusion imaging in patients with chronic obstructive pulmonary disease and smokers with normal pulmonary function

Objective To observe the difference of pulmonary perfusion imaging in patients with chronic obstructive pulmonary disease (COPD) and smokers with normal pulmonary function. Methods All of 63 patients with COPD and 20 smokers with normal pulmonary function (control group) underwent CTPI. COPD patients were divided into mild, moderate, severe and extremely severe COPD subgroups. CT value ratio (R_HU) of perfusion defect area and normal area were calculated at lobe level. The differences of body mass index (BMI), smoking and lung R_HU were compared. Results There was significant difference of BMI between control group and severe and extremely severe COPD subgroups (P=0.006, 0.002), as well as between control group and extremely severe COPD subgroup (P=0.007). There was no significant difference of R_HU at lobe level in each group (all P>0.05). There was significant difference between R_HU for the right lung lobe of control group and that in severe and extremely severe COPD subgroups (P=0.03, 0.02), but not among other lobes in each groups (all P>0.05). There was significant difference between R_HU in control group and each COPD subgroups (all P<0.05), between mild and moderate COPD (P=0.022), mild and extremely severe COPD (P=0.001), as well as moderate and extremely severe COPD subgroups (P=0.003). Conclusion R_HU can distinguish COPD and smokers with normal pulmonary function, which may become a predictor of the severity for COPD.