Quantitative Computed Tomography Measures of Emphysema and Airway Wall Thickness Are Related to Respiratory Symptoms
Quantitative Computed Tomography Measures of Emphysema and Airway Wall Thickness Are Related to Respiratory Symptoms
复制标题
DOI：
10.1164/rccm.200907-1008oc
复制
发表时间：
2010-02-15
影响因子：
24.7
通讯作者：
Bakke, Per S.
中科院分区：
文献类型：
--
作者：
Grydeland, Thomas B.;Dirksen, Asger;Bakke, Per S.
理由。关于呼吸系统症状与肺气肿和气道壁厚度的定量高分辨率计算机断层扫描测量之间的关系的知识有限。Objectives：描述肺气肿和气道壁厚度的这些测量预测慢性阻塞性肺疾病（COPD）患者和非COPD患者呼吸系统症状的能力。我们纳入了463例慢性阻塞性肺疾病（COPD）受试者（65%男性）和488例非COPD受试者（53%男性）。所有受试者均为40岁以上的吸烟者或既往吸烟者。他们接受了肺功能测定和高分辨率计算机断层扫描检查，并完成了美国胸科学会关于呼吸系统症状的问卷调查。中值（第25百分位数，第75百分位数）小于-950 Hounsfield单位（%LAA）的低衰减面积百分比为7.0（2.2，17.8），非COPD受试者为0.5（0.2，1.3）。内周长10 mm处的标准化气道壁厚度（AWT-Pi 10）平均值（SD）在COPD受试者中为4.94（0.33）mm，在非COPD受试者中为4.77（0.29）mm。在COPD受试者中，%LAA和AWT-Pi 10均与呼吸困难水平独立且显著相关，即使在校正FEV 1预测值百分比后也是如此。AWT-Pi 10与COPID受试者的咳嗽和喘息显著相关，与非COPD受试者的喘息显著相关。比值比COPD受试者和非COPD受试者中呼吸困难增加的95%置信区间为1.9（1.5-2.3）和1.9（0.6-6.6）%LAA每增加10%，和1.07（1.01-1.14）和1.11（0.99-1.24）每增加0.1毫米的AWT-Pi 10。肺实质和气道的定量计算机断层扫描评估可用于解释信息以外的呼吸道症状的存在通过肺量测定法提供。
Rationale. There is limited knowledge about the relationship between respiratory symptoms and quantitative high-resolution computed tomography measures of emphysema and airway wall thickness.Objectives: To describe the ability of these measures of emphysema and airway wall thickness to predict respiratory symptoms in subjects with and without chronic obstructive pulmonary disease (COPD).Methods: We included 463 subjects with chronic obstructive pulmonary disease (COPD) (65% men) and 488 subjects without COPD (53% men). All subjects were current or ex-smokers older than 40 years. They underwent spirometry and high-resolution computed tomography examination, and completed an American Thoracic Society questionnaire on respiratory symptoms.Measurements and Main Results: Median (25th percentile, 75th percentile) percent low-attenuation areas less than -950 Hounsfield units (%LAA) was 7.0 (2.2, 17.8) in subjects with COPD and 0.5 (0.2, 1.3) in subjects without COPD. Mean (SD) standardized airway wall thickness (AWT) at an internal perimeter of 10 mm (AWT-Pi10) was 4.94 (0.33) mm in subjects with COPD and 4.77 (0.29) in subjects without COPD. Both %LAA and AWT-Pi10 were independently and significantly related to the level of dyspnea among subjects with COPD, even after adjustments for percent predicted FEV1. AWT-Pi10 was significantly related to cough and wheezing in subjects with COPID, and to wheezing in subjects without COPD. Odds ratios (95% confidence intervals) for increased dyspnea in subjects with COPD and in subjects without COPD were 1.9 (1.5-2.3) and 1.9 (0.6-6.6) per 10% increase in %LAA, and 1.07 (1.01-1.14) and 1.11 (0.99-1.24) per 0.1-mm increase in AWT-Pi10, respectively.Conclusions: Quantitative computed tomography assessment of the lung parenchyma and airways may be used to explain the presence of respiratory symptoms beyond the information offered by spirometry.