HRCT测量支气管哮喘的气道壁厚度与其病情严重度及肺功能的相关性研究

目的高分辨率CT(HRCT)测量不同程度的支气管哮喘患者支气管管壁厚度,并评估与病情严重度和肺功能损害的相关性。方法用HRCT扫描支气管哮喘患者35例,其中轻度13例、中度12例、重度10例。正常对照组20例。测量支气管壁横截面的气道壁的外径D和内径L,通过公式计算出支气管管壁厚度与外径比值(T/D)、气道壁面积占气道总截面积百分比(WA%)。计算观察指标与病情严重度及肺功能的相关性。结果支气管哮喘患者与正常组的T/D、WA%之间均有显著差异(P<0.01)。重度、中度支气管哮喘患者较轻度患者的T/D、WA%明显增加(P<0.01)。T/D、WA%与病情严重度呈正相关(P<0.01),WA%与FEV1呈负相关性(P<0.01)。结论重度、中度支气管哮喘患者较轻度及正常对照组的支气管壁明显增厚,且增厚程度与病情严重度及气道阻塞有关。

Correlation study on airway wall thickness with lung function and severity in patients with bronchial asthma assessed by high-resolution CT

Objective To assess the relationship between airway wall thickness with lung function and severity by high resolution CT(HRCT).Methods HRCT were performed in 35 asthmatic patients,13 patients with mild asthma,12 patients with moderate asthma,10 patients with severe asthma and 20 healthy subjects.Measurement of total airway diameter(D)and lumen diameter(L)then calculated the airway wall thickness(T)and wall thickness to airway diameter ratio(T/D)and the percentage of airway wall area to total airway cross sectional area(WA%).Relationships were assessed between the measurements and lung function and severity.Results T/D and WA% were significantly different between asthma group and healthy subjects group(P<0.01).Severe asthma and moderate asthma has higher T/D,WA% than mild asthma(P<0.01).T/D and WA% were strongly correlated with asthma severity(P<0.01).WA% negatively correlated only with FEV1(P<0.01).Conclusion Airway wall thickness was more increased in severe asthma and moderate asthma than mild asthma and healthy subjects.The degree of airway wall thickening related to the severity of disease and the degree of airflow obstruction.