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目的分析1~4级肺动脉(PA)管径与肺功能及CT肺容积参数的相关性。方法通过曲面重组方法测量48例慢性阻塞性肺疾病(COPD)患者肺动脉干(A1)、左/右肺动脉(LA2/RA2)、右肺上叶肺动脉(RUA3)、左/右肺下叶肺动脉(LLA3/RLA3)、右肺上叶尖段肺动脉(RUA4)、左肺上叶前段肺动脉(LUA4)、右肺中叶外段肺动脉(RMA4)、左/右肺下叶背段肺动脉(LLA4/RLA4)的管径,评价其与肺功能指标FEV1、FEV1%、FVC、FEV1/FVC、MEF25、MEF25%及CT肺容积参数[全肺容积(TLV)、肺气肿容积(TEV)、肺气肿指数(EI)]的关系。结果第1级PA管径慢性阻塞性肺疾病全球倡议(GOLD)仅Ⅰ与Ⅱ级、Ⅱ与Ⅲ级存在差异(P=0.009,P=0.002)。第2级PA管径GOLDⅠ与Ⅱ级、Ⅱ与Ⅲ级、Ⅱ与Ⅳ级存在差异(P=0.003;P=0.034,P=0.043;P=0.041)。第3级PA管径GOLDⅠ与Ⅲ、Ⅰ与Ⅳ级存在差异(P=0.004,P=0.024;P=0.009,P=0.003)。第4级PA管径GOLDⅠ与Ⅱ、Ⅰ与Ⅲ、Ⅰ与Ⅳ、Ⅱ与Ⅳ及Ⅲ与Ⅳ级存在差异(P=0.015;P=0.019,P=0.000;P=0.000,P=0.000,P=0.015;P=0.006,P=0.006,P=0.006,P=0.018;P=0.027)。第1~2级PA管径与肺功能指标无相关性。第3级PA管径与肺功能指标呈弱负相关性(r=-0.289~-0.486)。第4级PA管径与肺功能指标呈中等正相关性(r=0.378~0.716)。第1~2级PA管径与CT肺容积参数无相关性,第3级部分PA管径与CT肺容积参数呈中等正相关性(r=0.415~0.551),第4级PA除RUA4、LUA4外,其余4级PA管径均与所有CT肺容积参数呈弱至中等负相关性(r=-0.366~-0.717)。结论随着COPD患者PA管径的变细,不同GOLD级别间的差异也越显著。第3级PA管径随着肺功能指标的减小和CT肺容积参数的增高而增宽,而第4级PA管径则变窄。第4级PA管径与肺功能指标及EI的相关性较第3级PA大。FEV1%、FEV1/FVC及TEV、EI与第3~4级PA的相关性较高。
Objective To analyze the correlation between the diameter of pulmonary artery (PA) and the pulmonary function and the volume of CT lung in grade 1-4. Methods 48 cases of chronic obstructive pulmonary disease (COPD) were measured by surface reshaping method. The pulmonary artery (A1), left / right pulmonary artery (LA2 / RA2), right upper pulmonary artery (RUA3), left / LLA3 / RLA3, RUA4, LUA4, RMA4 and LLA4 / RLA4 in the right upper lobe of pulmonary arteries, (FEV1, FEV1%, FVC, FEV1 / FVC, MEF25, MEF25% and CT volumetric parameters [total lung volume (TLV), emphysema volume (EI)] relationship. Results The grade 1 PA global diameter of the global initiative for chronic obstructive pulmonary disease (GOLD) only differed from Grade Ⅱ, Ⅱ and Ⅲ (P = 0.009, P = 0.002). Grade 2 PA diameter GOLD Ⅰ and Ⅱ, Ⅱ and Ⅲ grade, Ⅱ and Ⅳ grade difference (P = 0.003; P = 0.034, P = 0.043; P = 0.041). Grade 3 PA diameter GOLD Ⅰ and Ⅲ, Ⅰ and Ⅳ differences (P = 0.004, P = 0.024; P = 0.009, P = 0.003). There was a significant difference between the 4th grade PA diameter GOLDⅠ and Ⅱ, Ⅰ and Ⅲ, Ⅰ and Ⅳ, Ⅱ and Ⅳ and Ⅲ and Ⅳ (P = 0.015, P = 0.000, P = 0.000, P = 0.000, P = 0.015; P = 0.006, P = 0.006, P = 0.006, P = 0.018; P = 0.027). Grade 1 to 2 PA diameter and pulmonary function index no correlation. Grade 3 PA diameter and pulmonary function indicators showed a weak negative correlation (r = -0.289 ~ -0.486). Grade 4 PA diameter was positively correlated with pulmonary function (r = 0.378 ~ 0.716). There was no correlation between the diameters of PA and CT lung volume in grade 1 and 2, and moderately positive correlation between the diameter of PA and the volume of CT in grade 3 (r = 0.415-0.551), the grade 4 PA in addition to RUA4 and LUA4 In addition, all other 4-stage PA diameters showed weak to moderate negative correlation with all CT lung volume parameters (r = -0.366 ~ -0.717). Conclusions With the narrowing of PA diameter in patients with COPD, the difference between different GOLD levels is also more significant. Grade 3 PA diameter narrowed as pulmonary function parameters and CT lung volume parameters increased, whereas Grade 4 PA tubing narrowed. Grade 4 PA diameter and pulmonary function index and EI correlation than PA level 3 large. FEV1%, FEV1 / FVC and TEV, EI and grade 3 to 4 PA higher correlation.