董中兴,沈慧君,龚李艳,闫如意.MSCT测量各个肺叶低密度区容积百分比及其对COPD患者肺功能受损及严重[J].内科急危重症杂志,2017,23(5):
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| DOI： |
| 中文关键词: MSCT COPD LAA% 肺功能 |
| 英文关键词:MSCT COPD LAA% lung function |
| 基金项目: |
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| 中文摘要: |
| 目的：利用MSCT测量各个肺叶LAA%并评估其对COPD患者肺功能受损及严重程度。方法：利用随机选取法选取我院2015-2016年确诊为COPD患者60例做为实验组,其中将实验组按照《慢性阻塞性肺疾病诊断标准(WS 318-2010)》将COPD患者划分为GOLD1级轻度(FEV1/FVC<70%、FEV1≥80%)15例、GOLD2级中度(FEV1/FVC<70%、50%≤FEV1<80%)17例、GOLD3级重度(FEV1/FVC<70%、30%≤FEV1<50%)20例、GOLD4级超重度（FEV1<30%)8例，选择健康人28例做为对照组，并对所有受试者行肺部CT检查以测量和计算出出各个肺叶的LAA%、对所有受试者行肺部功能检查以测量和计算出FEV1%、FEV1/FVC、RV/TLC、DLCO%，运用线性回归分析以研究MSCT测量出的LAA%与FEV1%、FEV1/FVC、RV/TLC、DLCO%的关系、运用协方差分析比较不同的LAA%。结果：全肺各区的LAA%与FEV1%、FEV1/FVC差异均有统计学意义（P<0.05），其中左肺下叶LAA%与FEV1%关系最密切、右肺下叶LAA%与FEV1/FVC关系最密切；除了右肺中下叶的LAA%与DLCO%、RV/TLC差异无统计学意义（P>0.05）外，其他肺叶区的LAA%与DLCO%、RV/TLC差异均有统计学意义（P<0.05），其中左肺下叶LAA%与DLCO%、RV/TLC关系最密切；对照组的FEV1%、FEV1/FVC、DLCO%均比实验组高，且随着COPD的级别越高（越高越严重）FEV1%、FEV1/FVC、DLCO%值越低，差异均有统计学意义（P<0.05）；实验组中的GOLD1组的右肺LAA%、右肺上叶LAA%及总LAA%与对照组比较差异有统计学意义（P<0.05）。结论：各个肺叶LAA%可反映出COPD患者肺功能的受损，而且LAA%越高各个肺叶肺功能的受损程度越严重 |
| 英文摘要: |
| Objective To evaluate the damage of lung function and severity in COPD patients by LAA% of each lung which were measured by MSCT. Methods 60 patients as the experimental group whose were diagnosed as this disease were selected in our hospital during 2015 to 2016 by the method of random selection, and according to "diagnosis criteria for chronic obstructive pulmonary disease(WS 318-2010) 15 cases were divided COPD GOLD1 (FEV1/FVC<70%、FEV1≥80%), 17 cases were divided COPD GOLD2(FEV1/FVC<70%、50%≤FEV1<80%), 20 cases were divided COPD GOLD3 (FEV1/FVC<70%、30%≤FEV1<50%), 8 cases were divided COPD GOLD4 (FEV1<30%). 28 cases of healthy people were selected as control group. All subjects were checked with pulmonary CT examination to measure and calculate all of the lung LAA%, and all the subjects were checked with pulmonary function examination to measure and calculate the FEV1%, FEV1/FVC, RV/TLC, DLCO%. We used linear regression analysis to study the relationship of LAA% with FEV1%、FEV1/FVC、RV/TLC、DLCO%, and we used covariance analysis to compare with the difference of LAA%. Results LAA% and FEV1%, FEV1/FVC covariance of whole lung regions were statistically significant difference (P<0.05), which LAA% of lower lobe of left lung most closely related with FEV1%, and LAA% of lower lobe of right lung most closely related with FEV1/FVC; In addition to LAA% and DLCO%, RV/TLC in the middle and lower lobe of right lung were not significant difference (P>0.05), and in other lobe area, there were statistically significant difference (P<0.05), which LAA% of lower lobe of left lung most closely related with DLCO%、RV/TLC; FEV1%, FEV1/FVC, DLCO% of control group were higher than the experimental group, and with the level of COPD was higher (more serious) FEV1%, FEV1/FVC, DLCO% value was low, which differences were statistically significant (P<0.05); There was a significant difference (P<0.05) between right lung LAA%, right upper lobe LAA% and total LAA% of the GOLD1 group and the control group. Conclusion LAA% could reflect the lung function damaged of COPD patients, and the higher LAA% the lung function in all of the lung were more serious |
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