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纸质出版:2011
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张旭升,邹利光,白莉,张松,王长征,梁开运.哮喘与慢性阻塞性肺疾病支气管改变的HRCT定量研究[J].陆军军医大学学报(原第三军医大学学报),2011,33(06):611-614.
Zhang Xusheng,Zou Liguang,Bai Li,Zhang Song,Wang Changzheng,Liang Kaiyun.Bronchial changes in asthma and chronic obstructive pulmonary disease: a quantitative study by high resolution computed tomography[J].J Amry Med Univ (J Third Mil Med Univ),2011,33(06):611-614.
张旭升,邹利光,白莉,张松,王长征,梁开运.哮喘与慢性阻塞性肺疾病支气管改变的HRCT定量研究[J].陆军军医大学学报(原第三军医大学学报),2011,33(06):611-614. DOI:
Zhang Xusheng,Zou Liguang,Bai Li,Zhang Song,Wang Changzheng,Liang Kaiyun.Bronchial changes in asthma and chronic obstructive pulmonary disease: a quantitative study by high resolution computed tomography[J].J Amry Med Univ (J Third Mil Med Univ),2011,33(06):611-614. DOI:
目的 通过对哮喘和慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者胸部高分辨率CT(high resolution computed tomography
HRCT)扫描,探讨哮喘和COPD患者段和亚段支气管重塑的差异。 方法 哮喘34例,COPD 32例,正常对照24例,胸部HRCT扫描,对双上肺尖段及亚段、双下肺后基底段及亚段支气管进行描述性观察和定量分析,采用支气管自动分析软件Thoracic VCAR分别测量4支段和亚段支气管的壁厚度(wall thickness
WT)、腔内径(inner diameter
Din)、壁面积(wall area
WA)和壁面积百分比(WA%),并计算平均值,分析3组间各指标的差异。 结果 哮喘和COPD患者支气管改变表现为支气管壁增厚和管腔变窄。哮喘和COPD患者段支气管各参数的组间比较:WT和WA无统计学差异(P0.05);哮喘Din小于COPD(P0.05);哮喘WA%大于COPD(P0.05)。哮喘和COPD患者亚段支气管各参数的组间比较:哮喘WT、WA 和WA%均小于COPD(P0.05);哮喘Din大于COPD(P0.05)。 结论 哮喘和COPD患者有不同程度的支气管重塑,表现为支气管壁增厚和管腔变窄,哮喘患者的气道重构在段和亚段支气管均较明显,COPD患者的气道重构在亚段支气管较明显。
Objective To investigate the differences of airway remodeling in segmental and sub-segmental bronchi between bronchial asthma and chronic obstructive pulmonary disease (COPD) patients by high resolution computed tomography (HRCT). Methods HRCT (120 kV
80 to 280 mA
0.6 s) were performed in 34 asthmatic patients
32 COPD patients and 24 health subjects in our department form April 1
2009 to July 20
2010. All these asthmatic patients and COPD patients met the inclusion criteria of the Global Initiative for asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) respectively. Image reconstruction was carried out with a 5 mm collimation at 5 mm intervals and 0.625 mm collimation at 0.625 mm intervals respectively. CT images of segmental bronchi and sub-segmental bronchi were reviewed quantitatively and descriptively. Wall thickness (WT)
inner diameter (Din)
and wall area (WA)
percentage of wall area (WA%) of upper lobe apical segmental and sub-segmental bronchi in the right and left lung
as well as in lower lobe posterior basal segmental and sub-segmental bronchi of right and left lung were detected by bronchus automatic analysis software Thoracic VCAR. The mean values of the 4 parameters were calculated and the differences of these parameters between groups were analyzed. Results Bronchial wall thickening and luminal narrowing were found in asthma and COPD patients
and bronchiectasis in some cases. The comparison of segmental bronchi parameters between asthma and COPD patients: there was no difference of WA and WA between 2 groups (P0.05); Din of asthma was smaller than that of COPD (P0.05); WA% asthma was larger than that of COPD (P0.05). The comparison of sub-segmental bronchi parameters between 2 groups: WT
WA and WA% of asthma was smaller than those of COPD (P0.05); Din of asthma was larger than that of COPD (P0.05). Conclusion Bronchial remodeling in asthma and COPD patients manifests as bronchial wall thickening and luminal narrowing. Airway remodeling of asthma patients has both in segmental and sub-segmental bronchi
and airway remodeling of COPD patients is more apparent in sub-segmental bronchi.
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