64排多层螺旋CT低剂量双相扫描肺密度对慢性阻塞性肺疾病患者肺功能的评估价值

摘要

目的 探讨64排多层螺旋CT低剂量双相扫描肺密度用于评估慢性阻塞性肺疾病(COPD)患者肺功能的价值.方法 选取2017年1月至2018年2月在河北省胸科医院治疗的COPD患者67例作为COPD组,同期选取健康志愿者50例作为对照组,均给予64排多层螺旋CT低剂量双相扫描肺密度检查,评价肺功能相关指标差异并分析其相关性.结果 COPD组深吸气末密度(Din)、深呼气末密度(Dex)、密度差(Dex-Din)和密度变化百分比[(Din-Dex)/Din]明显低于对照组,而Dex/Din明显高于对照组[(-860±60)Hu比(-830±54)Hu、(-801±80)Hu比(-701±76)Hu、(59±23) Hu比(125±41)Hu、(0.07±0.01)比(0.17±0.16)、(0.97±0.26)比(0.85 ±0.21)],差异均有统计学意义(均P＜0.01).COPD组第1秒用力呼气容积占预计值百分比(FEV1％)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC％)明显低于对照组[(55±12)％比(89±11)％、(57±13)％比(83±12)％],差异均有统计学意义(均P＜0.05).FEV1％与Dex、Dex-Din和(Din-Dex)/Din呈正相关(r=0.487、0.511、0.522,均P＜0.05),与Dex/Din呈负相关(r=-0.477,P＜0.05);FEV1/FVC％与Din、Dex、Dex-Din和(Din-Dex)/Din呈正相关(r=0.422、0.563、0.521、0.517,P＜0.05),与Dex/Din呈负相关(r=-0.500,P＜0.05).结论 64排多层螺旋CT低剂量双相扫描肺密度可用于评价COPD患者肺功能情况.%Objective To investigate the value of 64-slice CT low-dose dual-phase scanning lung density in the evaluation of pulmonary function in patients with chronic obstructive pulmonary disease (COPD).Methods From January 2017 to February 2018,67 patients with COPD (COPD group) and 50 healthy people (control group) were recruited in Hebei Chest Hospital.All subjects had 64-slice CT low-dose dual-phase scanning;lung density and lung function indexes were analyzed.Results Deep end-inspiratory density (Din),deep end-expiratory density (Dex),density difference (Dex-Din) and density change percentage [(Din-Dex)/Din]in COPD group were significantly lower and Dex/Din was significantly higher than those in control group [(-860 ±60)Hu vs (-830 ±54)Hu,(-801 ±80)Hu vs (-701 ±76)Hu,(59±23)Hu vs (125 ±41)Hu,(0.07 ± 0.01) vs (0.17 ± 0.16),(0.97 ± 0.26) vs (0.85 ± 0.21)] (all P ＜ 0.05).Forced expiratory volume in the first second as a percentage of the predicted value(FEV1 ％) and the ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC％) in COPD group were significantly lower than those in control group[(55 ±12)％ vs (89±11)％,(57 ±13)％ vs (83 ±12)％](all P＜0.05).FEV1％ was positively correlated with Dex,Dex-Din and (Din-Dex)/Din (r =0.487,0.511,0.522;all P ＜ 0.05) and negatively correlated with Dex/Din (r =-0.477;P ＜ 0.05);FEV1/FVC％ was positively correlated with Din,Dex,Dex-Din and (Din-Dex)/Din (r =0.422,0.563,0.521,0.517;all P ＜ 0.05) and negatively correlated with Dex/Din(r =-0.500;P ＜ 0.05).Conclusion 64-slice CT low-dose dual-phase scanning lung density can be used to evaluate the lung function of COPD patients.