Influence of Emphysema and Air Trapping Heterogeneity on Pulmonary Function in Patients with COPD

被引:14
作者
Li, Kun [1 ]
Gao, Yanli [1 ]
Pan, Zhenyu [1 ]
Jia, Xiuqin [1 ]
Yan, Yuchang [1 ]
Min, Xiaohong [1 ]
Huang, Kewu [2 ]
Jiang, Tao [1 ]
机构
[1] Capital Med Univ, Beijing Chao Yang Hosp, Dept Radiol, Beijing, Peoples R China
[2] Capital Med Univ, Beijing Chao Yang Hosp, Beijing Inst Resp Med, Dept Pulm & Crit Care Med, Beijing, Peoples R China
来源
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE | 2019年 / 14卷
关键词
pulmonary disease; chronic obstructive; small airway disease; heterogeneous distribution; tomography; X-Ray computed; REGIONAL-DISTRIBUTION; LUNG; CT; DISEASE; COHORT;
D O I
10.2147/COPD.S221684
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Purpose: To explore the influence of emphysema and air trapping heterogeneity on pulmonary function changes in patients with stable chronic obstructive pulmonary disease (COPD). Patients and methods: One hundred and seventy-nine patients with stable COPD were enrolled in this prospective study. All patients underwent low-dose inspiratory and expiratory CT scanning and pulmonary-function tests. CT quantitative data for the emphysema index (EI) on full-inspiration and air trapping (AT) on full-expiration were measured for the whole lung, the right and left lungs, and the cranial-caudal lung zones. The heterogeneity index (HI) values for emphysema and air trapping were determined as the ratio of the difference to the sum of the respective indexes. The cranial-caudal HI and left-right lung HI were compared between mild-to-moderate (GOLD stage I and II) and severe (GOLD stage III and IV) disease groups. The associations between HI and pulmonary-function measurements adjusted for age, sex, height, smoking history, EI and AT of the total lung were assessed using multiple linear regression analysis. Results: The absolute values for cranial-caudal HI (AT_CC_HI) and left-right lung HI (AT_LR_HI) on full-expiration were significantly larger in the mild-to-moderate group, while no significant intergroup differences were observed on full-inspiration. COPD patients with lower-zone and/or left-lung predominance showed significantly lower pulmonary function than those with upper-zone and/or right-lung predominance on full-expiration, whereas no significant differences were observed on full-inspiration. The absolute values of AT_CC_HI and AT_LR_HI significantly correlated with pulmonary-function measurements. Higher AT_CC_HI and lower AT_LR_HI absolute values indicated better pulmonary function, after adjusting for age, sex, height, smoking history, EI and AT of the total lung. Conclusion: Subjects with more heterogeneous distribution and/or upper-zone predominant and/or right-lung predominant patterns on full-expiration tend to have better pulmonary function. Thus, in comparison with emphysema heterogeneity, AT heterogeneity better reflects the pulmonary function changes in COPD patients.
引用
收藏
页码:2863 / 2872
页数:10
相关论文
共 22 条
[11]   Impact of Emphysema Heterogeneity on Pulmonary Function [J].
Ju, Jieyang ;
Li, Ruosha ;
Gu, Suicheng ;
Leader, Joseph K. ;
Wang, Xiaohua ;
Chen, Yahong ;
Zheng, Bin ;
Wu, Shandong ;
Gur, David ;
Sciurba, Frank ;
Pu, Jiantao .
PLOS ONE, 2014, 9 (11)
[12]   Optimal threshold of subtraction method for quantification of air-trapping on coregistered CT in COPD patients [J].
Lee, Sang Min ;
Seo, Joon Beom ;
Lee, Sang Min ;
Kim, Namkug ;
Oh, Sang Young ;
Oh, Yeon-Mok .
EUROPEAN RADIOLOGY, 2016, 26 (07) :2184-2192
[13]   Computed tomographic emphysema distribution: relationship to clinical features in a cohort of smokers [J].
Mair, G. ;
Miller, J. J. ;
McAllister, D. ;
Maclay, J. ;
Connell, M. ;
Murchison, J. T. ;
MacNee, W. .
EUROPEAN RESPIRATORY JOURNAL, 2009, 33 (03) :536-542
[14]   Standardisation of spirometry [J].
Miller, MR ;
Hankinson, J ;
Brusasco, V ;
Burgos, F ;
Casaburi, R ;
Coates, A ;
Crapo, R ;
Enright, P ;
van der Grinten, CPM ;
Gustafsson, P ;
Jensen, R ;
Johnson, DC ;
MacIntyre, N ;
McKay, R ;
Navajas, D ;
Pedersen, OF ;
Pellegrino, R ;
Viegi, G ;
Wanger, J .
EUROPEAN RESPIRATORY JOURNAL, 2005, 26 (02) :319-338
[15]   Comparison of low attenuation areas on computed tomographic scans between inner and outer segments of the lung in patients with chronic obstructive pulmonary disease: incidence and contribution to lung function [J].
Nakano, Y ;
Sakai, H ;
Muro, S ;
Hirai, T ;
Oku, Y ;
Nishimura, K ;
Mishima, M .
THORAX, 1999, 54 (05) :384-389
[16]  
Bastos HNE, 2015, J BRAS PNEUMOL, V41, P489
[17]  
Pauwels R A, 2001, Respir Care, V46, P798
[18]   Lobar distribution of emphysema in computed tomographic densitometric analysis [J].
Saitoh, T ;
Koba, H ;
Shijubo, N ;
Tanaka, H ;
Sugaya, F .
INVESTIGATIVE RADIOLOGY, 2000, 35 (04) :235-243
[19]   Sonographic evaluation of diaphragmatic dysfunction in COPD patients [J].
Scheibe, Nadine ;
Sosnowski, Natalia ;
Pinkhasik, Alina ;
Vonderbank, Sandy ;
Bastian, Andreas .
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 2015, 10 :1925-1930
[20]   Emphysema distribution and annual changes in pulmonary function in male patients with chronic obstructive pulmonary disease [J].
Tanabe, Naoya ;
Muro, Shigeo ;
Tanaka, Shiro ;
Sato, Susumu ;
Oguma, Tsuyoshi ;
Kiyokawa, Hirofumi ;
Takahashi, Tamaki ;
Kinose, Daisuke ;
Hoshino, Yuma ;
Kubo, Takeshi ;
Ogawa, Emiko ;
Hirai, Toyohiro ;
Mishima, Michiaki .
RESPIRATORY RESEARCH, 2012, 13