摘要
目的:利用高分辨率CT(HRCT)探讨慢性稳定期哮喘患者的气道重塑。方法:选择7例健康人(正常对照组)、12例稳定期哮喘患者(哮喘组)和10例稳定期慢性支气管炎患者(慢性支气管炎组),对其进行肺功能测定,并在2d内分别在主动脉弓上缘、气管隆突和右膈上2cm水平处作HRCT扫描。HRCT扫描的层厚为2mm。在扫描过程中,所有受试者均处于用力吸气末。在每幅图像的前、中、后胸膜下5mm处选择50mm2的感兴趣区(ROI),并测其肺密度CT值。此外,对5例稳定期哮喘患者在吸入β2受体激动剂沙丁胺醇前后进行HRCT扫描和肺功能测定。另选择4例急性加重期哮喘患者,在急性加重期末和出院6周病情稳定后,分别行HRCT扫描和肺功能检查。结果:慢性稳定期哮喘患者肺密度的平均CT值为-904(-826～-958)HU,而慢性支气管炎患者的肺密度平均CT值为-943(-908～-992)HU,比哮喘患者低(P<0.05)。哮喘和慢性支气管炎患者肺密度的平均CT值均比正常者(平均-778HU,-760～-796HU)低(P<0.05)。哮喘和慢性支气管炎患者肺密度的平均CT值较为接近。5例慢性稳定期哮喘患者在使用沙丁胺醇气雾剂前后肺功能有改善,但肺密度平均CT值无变化(P>0.05)。4例急性发作期哮喘患者在加重期末和临床稳定6周后的肺功能也有改善,但肺密度平均CT值也无明显变化(P>0.05)。结论:部分慢性稳定期哮喘患者肺密度的平均CT值较正常人低,不受气体陷闭的影响,且与慢性支气管炎患者的肺气肿相似,从形态学上间接反映了哮喘患者的气道重塑。
Objective ：To explore the airway remodeling in patients with chronic stable asthma by highresolution CT（HRCT）. Methods ：Twelve patients with chronic stable asthma , 10 stable chronic bronchitis and 7 healthy controls were included. All subjects underwent pulmonary function test, and the HRCT scans were performed and 2 cm above the rightdiap at three selected levels ：superior margin of the aortic arch , tracheal carina, within a 2 day period. The thickness of section cuts was 2 mm. During the scan, the patient held his/her breath at the end of full inspiratory. The 50 mm^2 region of interest （ROI） 5 mm below pleura was chosen in the front, middle , and rear within all CT scan cuts respectively, and the value of the CT Lung density in these areas was measured . In five of the asthmatic patients CT scans and pulmonary function tests were performed before and after treatment with Salbutamo. In a different group of four asthmatics these measurements were performed at the end of and 6 weeks after an exacerbation. Results：The mean value of the CT Lung density in the patients with asthma was higher than that in the patients with chronic bronchitis（ -904 HU and -943 HU, P 〈 0.05 ）. Both the mean value of the CT Lung density in the patients with asthma and chronic bronchitis were lower than that in normal controls（ mean - 778 HU, - 760 HU - - 796 HU, P 〈 0.05 ） . There was a considerable overlap in the CT lung density between patients with asthma and chronic bronchitis. The pulmonary function after using sabutamol was improved and the value of the CT lung density did not change in five asthmatics （ P 〉 0.05 ）. In a different group of four asthmatics the pulmonary function was improved and the value of the CT lung density did not change at the end of and 6 weeks after an exacerbation （ P 〉 0.05 ）. Conclusion ：Some patients with chronic asthma develop a reduction in computed tomography lung density which is not affected by air trapping , similar to that in patients with chronic bronchitis, which morphologically reflect the airway remodeling in patients with asthma indirectly.
出处
《医学研究生学报》
CAS
2006年第4期352-355,共4页
Journal of Medical Postgraduates
