Objective: To evaluate the correlation of CT small airway measurement with clinical and inflammatory factors in asthma patients. Methods: From November 2014 to December 2015, a total of 20 patients with asthma were recruited in outpatient department of Peking University Third Hospital. All underwent asthma control test (ACT), CT and pulmonary function test. Serum leptin, immunoglobulin E(IgE) and transforming growth factor-β1(TGF-β1), induced sputum eosinophil percentage(Eos%) and matrix metalloproteinase(MMP-9) results were collected.Using GE airway analysis software and adjusted by body surface area, luminal diameter(LD(adjusted)), luminal area(Ai(adjusted)), wall thickness(WT(adjusted)) and wall area%(WA%)at the end of 6th generation airway were recorded. Results: In asthma patients with smoking history, both LD(adjusted) and Ai(adjusted) were significantly lower than patients without smoking history(LD(adjutsed) (1.19±0.14)vs(1.34±0.11) mm, Ai(adjusted) (1.13±0.32) vs (1.43±0.24) mm(2,) t=-2.459, -2.267, all P<0.05); in asthma patients with induced sputum Eos%≥3%, both LD(adjusted) and Ai(adjusted) were significantly lower but WA% significantly higher than patients with induced sputum Eos%<3% (LD(adjutsed) (1.26±0.05) vs (1.44±0.09) mm, Ai(adjusted)(1.27±0.11) vs (1.66±0.17) mm(2,) WA%(83.96%±1.26%) vs (81.20%±2.26%), t=-3.935, -4.492, 2.448, all P<0.05). LD(adjutsed) and Ai(adjusted) had negative correlation with course of disease and induced sputum Eos%(LD(adjutsed) r=-0.512, -0.841, Ai(adjusted) r=-0.489, -0.841, all P<0.05), and positive correlation with FEV(1)/FVC and serum leptin(LD(adjutsed) r=0.669, 0.533, Ai(adjusted) r=0.681, 0.552, all P<0.05). Ai(adjusted) also showed positive correlation with FEV(1)%(r=0.452, P<0.05). WT(adjusted) and WA% were significantly negative correlated with FEV(1)/FVC and FEV(1)%(WT(adjusted) r=-0.621, -0.483, WA% r=-0.729, -0.548, all P<0.05). WA% also showed positive correlation with serum IgE and induced sputum MMP-9(r=0.509, 0.636, all P<0.05). CT airway indexes showed no significantly correlation with age, ACT scores and serum TGF-β1. Conclusions: CT airway indexes are found partially associated with course of disease, smoking history, serum leptin and IgE, induced sputum Eos% and MMP-9. CT airway indexes show correlation with FEV(1)/FVC and FEV(1)%.
目的： 探讨支气管哮喘(简称哮喘)患者CT小气道参数与临床及炎症指标的相关性。 方法： 收集2014年11月至2015年12月在北京大学第三医院门诊诊断为哮喘的患者20例，均完成哮喘控制测定(ACT)、CT检查、肺功能，血清瘦素、免疫球蛋白E(IgE)及转化生长因子－β1(TGF－β1)测定，诱导痰嗜酸性粒细胞百分比(Eos%)及基质金属蛋白酶－9(MMP－9)测定。GE公司Airway Analysis软件测量6级气道远端内径<2 mm小气道经体表面积校正的气腔直径(LD(校正))、气腔面积(Ai(校正))、气道壁厚(WT(校正))及气道壁面积百分比(WA%)。 结果： 有吸烟史患者LD(校正)、Ai(校正)显著低于从不吸烟者[LD(校正)(1.19±0.14)比(1.34±0.11) mm，Ai(校正)(1.13±0.32)比(1.43±0.24) mm(2)，t＝－2.459、－2.267，均P<0.05]；诱导痰Eos%≥3%者LD(校正)、Ai(校正)显著低于、WA%显著高于诱导痰Eos%<3%者[LD(校正)(1.26±0.05)比(1.44±0.09) mm，Ai(校正)(1.27±0.11)比(1.66±0.17) mm(2)，WA%(83.96%±1.26%)比(81.20%±2.26%)，t＝－3.935、－4.492、2.448，均P<0.05]。LD(校正)、Ai(校正)均与病程、诱导痰Eos%负相关(LD(校正) r＝－0.512、－0.841，Ai(校正) r＝－0.489、－0.841，均P<0.05)，均与第1秒用力呼气量(FEV(1))和用力肺容积(FVC)之比(FEV(1)/FVC)、血清瘦素正相关(LD(校正) r＝0.669、0.533，Ai(校正) r＝0.681、0.552，均P<0.05)。Ai(校正)还与FEV(1)占预计值百分比(FEV(1)%)正相关(r＝0.452，P<0.05)。WT(校正)、WA%均与FEV(1)/FVC、FEV(1)%负相关(WT(校正) r＝－0.621、－0.483，WA% r＝－0.729、－0.548，均P<0.05)。WA%还与血清IgE、诱导痰MMP－9正相关(r＝0.509、0.636，均P<0.05)。CT小气道参数与患者年龄、ACT评分、血清TGF－β1均无显著相关性。 结论： 哮喘患者病程、有无吸烟史、血清瘦素及IgE、诱导痰Eos%及MMP－9可影响部分小气道CT参数。小气道CT参数与FEV(1)/FVC、FEV(1)%存在相关性。.
Keywords: Asthma; Bronchi; Cicatrix, hypertrophic.