Longitudinal study of airway dimensions in chronic obstructive pulmonary disease using computed tomography
Longitudinal study of airway dimensions in chronic obstructive pulmonary disease using computed tomography
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DOI：
10.1111/j.1440-1843.2008.01269.x
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发表时间：
2008-05-01
期刊：
影响因子：
6.9
通讯作者：
Mishima, Michiaki
中科院分区：
文献类型：
--
作者：
Ohara, Tadashi;Hirai, Toyohiro;Mishima, Michiaki
背景与目的：胸部CT在横断面研究中被广泛用于评估肺实质和气道的结构变化。目前尚无关于COPD患者CT评估气道尺寸年度变化的报道。本研究的目的是探讨COPD患者气道尺寸和肺衰减的年度CT变化，并评估CT测量值的年度变化与肺功能之间的相关性。方法：83名男性COPD患者在4年内完成了5次年度CT扫描评估和肺功能检查。我们分析了38名受试者的CT图像上的支气管基底段气道尺寸和肺衰减，这些受试者在研究开始和结束时至少可以测量三次相同的气道。结果：FEV1年平均下降21 mL/年。低衰减区百分比的年变化与FEV1的下降无显著相关。另一方面，壁面积百分比（WA%/年）的年变化与FEV1的年变化呈显著负相关（r = -0.363, P = 0.025），而WA%/年在进入时的严重程度阶段之间没有差异，也与基线FEV1无关。结论：气道增厚的年度变化与气流限制的年度下降相关，提示COPD气道炎症治疗的重要性。在纵向研究中，CT不仅是定量评估肺气肿的有用工具，而且也是气道病变的有用工具。
Background and objective: Chest CT has been widely used for the evaluation of structural changes in lung parenchyma and airways in cross-sectional studies. There has been no report on the annual changes in airway dimensions as assessed by CT in COPD patients. The objective of this study was to investigate the annual changes in airway dimensions and lung attenuation using CT in patients with COPD and to evaluate the correlations among annual changes in CT measurements and pulmonary function.Methods: Eighty-three men with COPD had completed five annual assessments of CT scans and pulmonary function tests over 4 years. Airway dimensions of the basal segment bronchi and lung attenuation on CT images were analysed in 38 subjects in whom the same airway could be measured at least three times, including at entry and at the end of the study.Results: Mean annual decline in FEV1 was 21 mL/year. Annual changes in the percentage of low attenuation areas were not significantly correlated with decline in FEV1. On the other hand, annual changes in the percentage of wall area (WA%/year) were significantly inversely correlated with annual changes in FEV1 (r = -0.363, P = 0.025), whereas WA%/year did not differ among severity stages at entry and did not correlate with baseline FEV1.Conclusions: The results showing that annual changes in airway thickening correlated with annual decline in air flow limitation suggests the importance of treatment of airway inflammation in COPD. CT is a useful tool for quantitative estimation not only of emphysema but also of airway lesions in longitudinal studies.