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目的采用氙增强胸部CT,观察哮喘病人吸入乙酰甲胆碱和沙丁胺醇后气道的动态变化及其与氙通气指数之间的相关性。材料与方法选取31例非吸烟受试者(正常人6例,哮喘病人25例)进行氙增强胸部CT和肺功能检查。影像检查共采集3次(基线状态、吸入乙酰甲胆碱后、吸入沙丁胺醇后),测量计算总的氙通气指数(TXVI)及气道参数值。统计分析采用重复测量方差分析和Spearman相关分析。结果正常人吸入乙酰甲胆碱和沙丁胺醇后,TXVI未见明显变化(P>0.05)。但是,哮喘病人吸入乙酰甲胆碱后TXVI明显减低,而吸入沙丁胺醇后TXVI明显升高(P<0.05)。在气道参数方面,哮喘病人所有气道的内面积在吸入沙丁胺醇后明显增加(P<0.01)。而吸入乙酰甲胆碱后气道的内面积、气道壁厚以及气道壁的面积百分比均未见明显减低(P>0.05)。大气道的内面积与基线状态的TXVI、FEV1和FVC具有良好的相关性(P<0.05)。结论哮喘病人的气道内面积是反映吸入乙酰甲胆碱和沙丁胺醇后气道动态变化最可靠的指标,与氙增强CT检查的TXVI具有良好的相关性。
Objective To evaluate the dynamic changes of airway after inhalation of methacholine and salbutamol in asthmatic patients by xenon enhanced chest CT and its correlation with xenon ventilation index. Materials and Methods 31 non-smoking subjects (6 normal subjects and 25 asthma subjects) were enrolled for xenon enhanced chest CT and pulmonary function tests. A total of three imaging examinations (baseline status, methacholine inhalation after inhalation of salbutamol) were measured and calculated total xenon ventilation index (TXVI) and airway parameters. Statistical analysis using repeated measures ANOVA and Spearman correlation analysis. Results After normal inhalation of methacholine and salbutamol, TXVI showed no significant change (P> 0.05). However, TXVI was significantly decreased in patients with asthma after inhalation of methacholine, and TXVI was significantly increased after salbutamol inhalation (P <0.05). In terms of airway parameters, the area of all airways in asthmatic patients increased significantly after salbutamol inhalation (P <0.01). However, no significant decrease was found in the area of airway, the airway wall and the area of airway wall after inhalation of methacholine (P> 0.05). There was a good correlation between the inner area of the airway and TXVI, FEV1 and FVC at baseline (P <0.05). Conclusion The airway area of asthmatic patients is the most reliable indicator of airway dynamic changes after methacholine inhalation and salbutamol inhalation, which is in good correlation with TXVI of xenon enhanced CT.