本文選題：肺疾病 + 慢性阻塞性��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:應(yīng)用多層螺旋CT(MSCT)對收集的COPD患者及正常志愿者分別于深吸氣末和深呼氣末行雙相掃描,通過測量小氣道相關(guān)參數(shù),分析COPD組與正常對照組小氣道各參數(shù)的差異及COPD組小氣道參數(shù)與肺功能指標的相關(guān)性,探討MSCT雙相掃描測量小氣道參數(shù)對診斷及評價COPD的可行性及臨床應(yīng)用價值。方法:收集76例COPD患者及14例健康志愿者,采用128層螺旋CT分別于深吸氣末和深呼氣末對受試者行全肺掃描;在不超過一周內(nèi)行肺功能檢查;應(yīng)用后處理軟件測量每位患者左肺上葉尖后段、右肺上葉尖段、左肺下葉后基底段、右肺下葉后基底段小氣道壁厚度(WT)、管腔面積(AI)、斷面總面積(AT),并計算壁面積(WA)、壁面積百分比(WA%);用兩獨立樣本t檢驗分別比較吸氣相、呼氣相正常對照組與COPD組小氣道WT、AI、WA、WA%之間的差異,并采用Pearson相關(guān)分析法分析COPD組吸氣相與呼氣相小氣道各參數(shù)和肺功能指標的相關(guān)性。結(jié)果:(1)呼氣相、吸氣相正常對照組與COPD組小氣道WT、AI、WA、WA%均有統(tǒng)計學差異(P0.05)。(2)COPD組吸氣相和呼氣相小氣道WT、AI、WA、WA%與肺功能FEV1、FEV1/FVC%均有相關(guān)性;且WT、WA、WA%與肺功能FEV1及FEV1/FVC%均呈負相關(guān),AI與肺功能FEV1及FEV1/FVC%呈正相關(guān)。(3)COPD組小氣道WT、AI、WA、WA%與肺功能FEV1、FEV1/FVC%相關(guān)系數(shù)呼氣相要高于吸氣相。(4)COPD患者呼氣相下小氣道WT、AI、WA、WA%與肺功能指標FEV1、FEV1/FVC%均有相關(guān)性,且下肺的相關(guān)系數(shù)高于雙肺上葉的相關(guān)系數(shù)。結(jié)論:COPD患者小氣道管壁壁厚度較正常健康者增厚,而管腔面積卻逐漸減小;采用MSCT呼吸雙相掃描對于評價COPD患者氣流受限是可行的,氣道壁厚、管腔面積、壁面積及壁面積百分比可以作為反映COPD患者氣道改變的指標;雙相掃描能更全面及動態(tài)地反應(yīng)COPD患者小氣道病變的情況;且雙肺下葉氣道壁增厚對于肺功能的影響較肺上葉大。
[Abstract]:Objective: to measure the parameters of small airway in COPD patients and normal volunteers by using multislice spiral CT scanning at deep inspiratory end and deep expiratory end, respectively.To analyze the difference of small airway parameters between COPD group and normal control group and the correlation between small airway parameters and pulmonary function index in COPD group, to explore the feasibility and clinical application value of MSCT biphasic scanning measurement of small airway parameters in diagnosis and evaluation of COPD.Methods: a total of 76 patients with COPD and 14 healthy volunteers were examined with 128-slice spiral CT at the end of deep inspiratory and deep expiratory, respectively.Postprocessing software was used to measure the posterior segment of the left superior lobe, the apical segment of the right lung, the posterior basal segment of the left lower lobe of the left lung, and the posterior basal segment of the left lower lobe of the left lung.The thickness of the small airway wall and the lumen area of the posterior basal segment of the right lower lobe of the right lung are WTT, and the lumen area is greater than that of the others. The total area of the section is calculated and the area of the wall is calculated, and the percentage of the wall area is calculated, and the inspiratory phase is compared with the t test of two independent samples.The difference of small airway WT-AIWA-WA% between normal expiratory control group and COPD group was analyzed by Pearson correlation analysis. The correlation between inspiratory and expiratory small airway parameters and pulmonary function index in COPD group was analyzed by Pearson correlation analysis.Results there was a significant difference in expiratory phase, inspiratory phase and COPD group. There was a significant correlation between inspiratory phase and expiratory small airway WTA / FEV1 / FVC%.The correlation coefficient of lower lung was higher than that of upper lobe of both lungs.Conclusion the wall thickness of small airway wall is thicker than that of normal controls, but the lumen area decreases gradually in the patients with COPD, and it is feasible to evaluate the airflow limitation by using MSCT breath biphasic scanning, the thickness of the airway wall and the area of the lumen of the patients with COPD, and the thickness of the airway wall and the area of the lumen.The wall area and the percentage of wall area can be used as indicators to reflect the airway changes in COPD patients; biphasic scanning can more comprehensively and dynamically reflect the condition of small airway lesions in patients with COPD; and the thickening of the wall of the inferior lobe of both lungs has a greater effect on the pulmonary function than that on the upper lobe of the lung.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.9;R816.41

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