| ObjectiveChronic obstructive pulmonary disease(COPD)for short,is one of the most common diseases of the respiratory system.It mainly involves the lung.Progressive dyspnea is the main clinical manifestation of COPD.With the continuous deterioration of lung function,the quality of life of patients decreases gradually,the treatment cost increases constantly,leading to serious economic and psychological burden.In the past,the pulmonary ventilation function test was commonly used as the gold standard for the diagnosis and evaluation of the degree of airflow restriction of COPD.However,COPD has differences in clinical manifestations,course progress,drug response,disease prognosis and other aspects.Simple pulmonary function can not accurately evaluate COPD.Chest CT has the ability to accurately reflect the small airway lesions,and can reflect the airway lesions in patients with COPD.This paper mainly discusses the correlation between CT small airway parameters and pulmonary function in patients with stable COPD.MethodsIn this study,58 patients with COPD in stable period who were followed up in Fuyang people's Hospital from December 2018 to January 2020 were collected as the study group,and 37 healthy people in the same period as the control group.The general data of height,weight,age,gender and so on were recorded.Both groups ofsubjects were examined with Siemens 256 row spiral CT in our hospital.The scanning parameters were set in the same way.After the scanning,the data was uploaded to air Six bronchi with diameter less than 2mm were selected from the right upper lobe apical branch,the lateral middle lobe outer branch,the posterior inferior lobe basal branch,the posterior left upper lobe apical branch,the anterior superior lingual branch and the posterior inferior lobe basal branch.The small airway wall thickness(before wt correction),the trachea cavity diameter(before LD correction)and the trachea were measured by experienced radiologists Cavity area(before AI correction),proportion of double lung emphysema(LAA%)data.Due to different body types,the body surface area was introduced.The wall thickness(WT corrected),diameter(LD corrected)and area(AI corrected)of the small airway after correction were recorded for data analysis.On the same day of chest CT examination,lung function examination was carried out.Senior doctors in our department measured the percentage of vital capacity in the predicted value(VC%),the ratio of residual volume to total lung volume(RV / TLC),the one second rate(FEV1 / FVC),the percentage of one second volume in the predicted value(FEV1%),the percentage of maximum expiratory mid-term flow rate in the predicted value(mmef75 / 25%)and other indicators with yeger lung function instrument.The study group was divided into light moderate pulmonary function group and heavy extremely severe pulmonary function group according to gold classification.The differences of small airway parameters between the two subgroups and the control group were compared,and the differences between small airway parameters and pulmonary function indexes in the study group were analyzed.The study group was divided into two groups according to whether the thickness of the small airway wall was 30% larger than the diameter of the accompanying pulmonary artery.Results1.There was no significant difference in age,height,weight and gender between thelight to moderate pulmonary function group,the heavy to extremely severe pulmonary function group and the control group(P = 0.088,P = 0.992,P = 0.241,P = 0.391).The corrected small airway wall thickness(WT corrected),the ratio of wall thickness to lumen diameter(T / D)(0.90 ± 0.16,0.68 ± 0.13)in the severe to extremely severe pulmonary function group was larger than that in the light to moderate pulmonary function group(0.56 ± 0.13)15,0.38 ± 0.12),the T / D of light to moderate lung function group was higher than that of control group(0.45 ± 0.17,0.29 ± 0.11),the difference was statistically significant.The corrected diameter(after LD correction)and the corrected area(after AI correction)(1.35 ± 0.08,1.44 ± 0.16)in the severe severe pulmonary function group were smaller than those in the light pulmonary function group(1.49 ± 0.07,1.74 ± 0.15)and the control group(1.49 ± 0.11,1.75 ± 0.25),with statistical difference(P < 0.001).There was no statistical difference between the light moderate pulmonary function group and the control group after LD correction and AI correction The difference was statistically significant(P > 0.05).LAA%in the severe severe pulmonary function group was higher than that in the light moderate pulmonary function group(P = 0.001)and the normal control group(P <0.001);LAA% in mild to moderate pulmonary function group was higher than that in normal control group(P = 0.029)?2.There was a certain correlation between pulmonary function indexes and CT small airway parameters(P < 0.05).After wt correction,LAA%,t / D were negatively correlated with FEV1 / FVC,FEV1%,VC%,mmef75 / 25%,and positively correlated with RV / TLC;after LD correction and AI correction,they were positively correlated with FEV1 / FVC,FEV1%,VC%,mmef75 / 25%,and negatively correlated with RV / TLC.3.There was no significant difference in age,gender,height and weight between the thickening group and the non thickening group(P > 0.05).The results showed that FEV1 / FVC,FEV1% and MMEF 75 / 25% in the thickening group were lower than those in the non thickening group(50.05 ± 9.40 / 57.69 ± 9.87,47.16 ± 10.74 / 58.44± 19.49,15.41 ± 3.86 / 28.06 ± 12.62).ConclusionIn COPD patients,the wall thickness of small airway increased,the diameter of trachea and the area of trachea decreased,that is to say,the degree of airway remodeling was higher and the range of emphysema was larger.There is a clear correlation between the parameters of small airway and the indexes of pulmonary function.Through the measurement of the parameters of airway,it can reflect the degree of expiratory airflow restriction and the range of emphysema.For the patients who can not carry out the examination of pulmonary function,the parameters of CT small airway can be used as an alternative index of pulmonary function evaluation,which has certain guiding significance in the clinical diagnosis and treatment of COPD. |
PDF Full Text Request