Airway wall thickness is increased in COPD patients with bronchodilator responsiveness
Airway wall thickness is increased in COPD patients with bronchodilator responsiveness
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DOI：
10.1186/s12931-014-0084-3
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发表时间：
2014-08-08
影响因子：
5.8
通讯作者：
Criner, Gerard J.
中科院分区：
文献类型：
--
作者：
Kim, Victor;Desai, Parag;Criner, Gerard J.
原理：支气管扩张剂反应性（BDR）是COPD中常见但可变的现象。区分COPD患者BDR与无BDR的气道尺寸的CT特征尚未得到很好的描述。我们的目的是评估COPD患者的气道大小，有和没有BDR。方法：我们分析了COPDGene（R）研究中GOLD 1-4疾病的受试者，他们进行了CT气道分析。我们将患者分为两组：BDR +（支气管扩张剂后Δ FEV 1>= 10%）和BDR-（支气管扩张剂后Δ FEV 1 < 10%）。采用维达法对每例受试者6个节段支气管的平均管壁面积百分比（WA%）进行定量。使用3D SLICER，气道壁厚度也表示为10 mm（Pi 10）和15 mm（Pi 15）直径气道壁面积的平方根。%肺气肿和%气体trapping.Results：2355例受试者在BDR-组和1306在BDR +组形成了我们的分析。与BDR组相比，BDR +组的Pi 10、Pi 15和平均节段WA%更大。在使用性别、种族、当前吸烟、哮喘史、%肺气肿、%气体潴留、%预测FEV 1和%预测FVC的多变量logistic回归中，气道壁测量仍然是BDR的独立预测因子。使用阈值变化FEV 1>= 15%和FEV 1>= 12%和200 mL将患者分组，结果相似。结论：COPD的BDR与气道病理的CT证据独立相关。这项研究为我们提供了更多的证据，肺结构的变化与COPD气流阻塞的生理表现相关。
Rationale: Bronchodilator responsiveness (BDR) is a common but variable phenomenon in COPD. The CT characteristics of airway dimensions that differentiate COPD subjects with BDR from those without BDR have not been well described. We aimed to assess airway dimensions in COPD subjects with and without BDR.Methods: We analyzed subjects with GOLD 1-4 disease in the COPDGene (R) study who had CT airway analysis. We divided patients into two groups: BDR + (post bronchodilator Delta FEV1 >= 10%) and BDR-(post bronchodilator Delta FEV1 < 10%). The mean wall area percent (WA%) of six segmental bronchi in each subject was quantified using VIDA. Using 3D SLICER, airway wall thickness was also expressed as the square root wall area of an airway of 10 mm (Pi10) and 15 mm (Pi15) diameter. %Emphysema and % gas trapping were also calculated.Results: 2355 subjects in the BDR-group and 1306 in the BDR + group formed our analysis. The BDR + group had a greater Pi10, Pi15, and mean segmental WA% compared to the BDR-group. In multivariate logistic regression using gender, race, current smoking, history of asthma, % emphysema, % gas trapping, % predicted FEV1, and % predicted FVC, airway wall measures remained independent predictors of BDR. Using a threshold change in FEV1 >= 15% and FEV1 >= 12% and 200 mL to divide patients into groups, the results were similar.Conclusion: BDR in COPD is independently associated with CT evidence of airway pathology. This study provides us with greater evidence of changes in lung structure that correlate with physiologic manifestations of airflow obstruction in COPD.