Airway dimensions in COPD: Relationships with clinical variables
Airway dimensions in COPD: Relationships with clinical variables
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DOI：
10.1016/j.rmed.2010.04.021
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发表时间：
2010-11-01
影响因子：
4.3
通讯作者：
MacNee, William
中科院分区：
文献类型：
--
作者：
Mair, Grant;Maclay, John;MacNee, William
背景：COPD患者存在不同程度的气道病变和肺气肿。CT扫描可以区分这些病理亚型。我们评估了气道尺寸和肺气肿的严重程度与低剂量CT扫描在COPD patients，以确定与临床特征的diseases.Methods的关系：56例COPD患者进行了低剂量胸部CT扫描。使用新型软件分析气道近端（第1代和第2代）或远端（第3代至第6代）;肺气肿的程度评估为小于-950亨氏场单位的像素百分比。结果：近端气道壁增厚与支气管炎的临床表现相关（MRC支气管炎评分; β = 0.20，p = 0.003，频繁加重; β = 0.14，p = 0.017，总St乔治评分; β = 0.50，p = 0.001和体重指数[BMI]; β = 0.26，p = 0.049）;这些相关性与肺气肿无关。BMI与肺气肿程度呈负相关（β = 0.41，p = 0.001）。近端和远端气道的气道壁厚度与CT测量的肺气肿呈负相关（r =-0.30，p = 0.025和r =-0.32，p = 0.015）。结论：CT测量的气道尺寸与COPD的几种临床指标相关;这些指标与支气管炎表型相关，且效果与肺气肿无关。(C)2010爱思唯尔有限公司版权所有。
Background: COPD patients have varying degrees of airways disease and emphysema. CT scanning can differentiate these pathological subtypes. We evaluated airway dimensions and emphysema severity with low dose CT scanning in COPD patients to determine relationships with clinical features of the disease.Methods: Fifty six patients with COPD had a low dose thoracic CT scan. Airways were analysed using novel software as either proximal (1st and 2nd generation) or distal (3rd to 6th generation); the extent of emphysema was assessed as the percentage of pixels less than -950 Houns-field units. CT measures were related to clinical features of COPD.Results: Thicker walls in the proximal airways were associated with clinical features that may represent a bronchitic phenotype (MRC Bronchitis Score; beta = 0.20, p = 0.003, Frequent Exacerbations; beta = 0.14, p = 0.017, Total St George's Score; beta = 0.50, p = 0.001 and body mass index [BMI]; beta = 0.26, p = 0.049); these associations were independent of emphysema. BMI was negatively correlated with the degree of emphysema (beta = 0.41, p = 0.001). Airway wall thickness was negatively correlated with CT measured emphysema for both proximal and more distal airways (r = -0.30, p = 0.025 and r = -0.32, p = 0.015).Conclusions: CT measured airway dimensions are associated with several clinical measures of COPD; these are related to a bronchitic phenotype and the effect is independent of emphysema. (C) 2010 Elsevier Ltd. All rights reserved.