慢性阻塞性肺疾病患者胸部多层螺旋CT定量参数及肺功能检测

  目的   分析慢性阻塞性肺疾病(COPD)患者胸部多层螺旋CT定量参数及肺功能检测结果。   方法   选取2018年8月~2021年9月我院收治的112例COPD患者，根据临床表型将支气管炎型COPD患者纳入支气管组(n=73)，将肺气肿型COPD患者纳入肺气肿组(n=39)，两组均行两次多层螺旋CT和肺功能检查，间隔4月，比较两组的肺容积指标深吸气末肺容积(Vin)、深呼气末肺容积(Vex)、Vex/Vin]，肺密度指标深吸气末平均肺密度(MLDin)、深呼气末平均肺密度(MLDex)、MLDex-MLDin]，肺功能指标1s用力呼气容积(FEV₁)、用力肺活量(FVC)、FEV₁/FVC]，采用Spearman法分析肺容积、肺密度指标与病情严重程度的相关性。   结果   两组患者末次的FEV₁、FEV₁/FVC低于首次，FVC高于首次，其中支气管炎组的变化幅度更明显(P < 0.05)；两组患者末次的Vin、Vex、Vex/Vin和MLDin、MLDex、MLDex-MLDin均低于首次，其中肺气肿组的下降幅度更明显(P < 0.05)；支气管炎型患者的两次肺功能测量差值FEV₁/FVC (%)与肺密度指标MLDex-MLDin呈正相关关系，肺气肿型患者的两次肺功能测量差值FEV₁和FEV₁/FVC与Vex/Vin、MLDex-MLDin均呈正相关关系(P < 0.05)。   结论   多层螺旋CT联合肺功能检测能显示不同表型COPD患者肺气肿以及支气管的变化，具有一定的临床价值。 

Quantitative parameters and pulmonary function test results of multi-slice spiral computed tomography in chronic obstructive pulmonary disease patients

  Objective   To explore quantitative parameters and pulmonary function test results of multislice spiral CT in chronic obstructive pulmonary disease (COPD) patients.   Methods   A totao of 112 COPD patients who were admitted to the hospital were enrolled between August 2018 to September 2021. According to different clinical phenotype of COPD, the patients with bronchitis COPD were divided into bronchitis group (n=73) and the patients with emphysema COPD were divided into emphysema group (n=39). All patients underwent two-time chest multislice spiral CT examinations and pulmonary function tests, with an interval of 4 months. The pulmonary volume indexes Vex/Vin], pulmonary density indexes Mean lung density at the end of deep inspiration (MLDin), mean lung density at the end of deep exhalation (MLDex), MLDex-MLDin] and pulmonary function indexes FEV₁, FVC, FEV₁/FVC] were compared between the two groups. The correlation between pulmonary volume indexes, pulmonary density indexes and disease severity was analyzed by spearman method.   Results   At the last time, FEV₁ and FEV₁/FVC of the two groups of patients were lower than the first time, and the FVC was higher than the first time (P < 0.05). Vin, Vex, Vex/Vin and MLDin, MLDex, MLDex-MLDin of the two groups of patients were lower than the first time (P < 0.05). The measured difference FEV₁/FVC (%) was positively correlated with the lung density index MLDex-MLDin, and the difference FEV₁ and FEV₁/FVC of the two pulmonary function measurements in patients with emphysema were positively correlated with Vex/Vin and MLDex-MLDin (P < 0.05).   Conclusion   Multislice spiral CT combined with pulmonary function test can show the changes of emphysema and bronchus in COPD patients with different phenotypes, which has certain clinical value.