摘要
目的 基于CT能谱成像探讨慢性阻塞性肺疾病(COPD)患者的严重程度与其骨质密度的相关性.方法 搜集2021年1月至2022年9月行肺功能检查及胸部能谱CT检查的患者共171例.记录肺功能指标一秒率(FEV1/FVC％)及第1秒用力呼气容积占预计值百分比(FEV1％pred).根据COPD诊断指南将患者分为5组,非COPD组(A组)、轻度COPD组(B组)、中度COPD组(C组)、重度COPD组(D组)、极重度COPD组(E组).利用GE AW4.7后处理工作站测量患者中段胸椎(T5～8)的骨密度能谱参数:羟基磷灰石(HAP)(水)、Ca(水)、HAP(脂)、能谱曲线斜率(λ),并得出其中段胸椎平均值.比较5组间骨密度能谱参数的差异性,分析COPD患者肺功能参数与其骨密度能谱参数的相关性.结果 5组间HAP(水)、钙(水)、HAP(脂)、λ差异均有统计学意义(P均＜0.001),多重比较均为:A组＞D组及E组,B组＞D组及E组,C组＞D组及E组(P均＜0.05).HAP(水)、钙(水)、HAP(脂)、λ与FEV1/FVC％均相关性一般(r均＜0.6,P均＜0.001),而与FEV1％pred均呈强正相关(r均＞0.6,P均＜0.001).结论 COPD患者肺功能受损程度的加重,尤其重度及以上水平,会导致骨质密度减低.
Abstract
Objective To analyze the difference of bone mineral density between non-Chronic obstructive pulmonary disease(COPD)patients and different grades of COPD patients.To analyze the correlation between bone mineral density and COPD severity in COPD patients.Methods A total of 171 patients who underwent lung function examination,and chest gemstone spectral imaging examination in our hospital from January 202 1 to September 2022 were collected.Pulmona-ry function test results,including FEV1/FVC％and FEVI％pred,were recorded.Patients were divided into group A(non-COPD),group B(mild COPD),group C(moderate COPD),group D(severe COPD),and group E(extremely severe COPD)according to the diagnostic guidelines for COPD.BMD spectral parameters,including HAP(water),calcium(wa-ter),HAP(fat)and λ,were measured in the middle thoracic vertebra(T5-8)of the patient using GE AW 4.7 post-pro-cessing workstation,and the mean value of the middle thoracic vertebra was obtained.The differences of bone mineral den-sity energy spectrum parameters among 5 groups were compared.The correlation between bone mineral density energy spec-trum parameters and lung function parameters in COPD patients was analyzed.Results HAP(water),Calcium(water),HAP(fat)and λof middle thoracic vertebra were significantly different among 5 groups(all P＜0.001).Multiple compari-son results show that,HAP(water),Calcium(water),HAP(fat)and λ were as follows:group A＞group D and E,group B＞group D and E,group C＞group D and E(all P＞0.05).HAP(water),Calcium(water),HAP(fat)and λ were gener-ally correlated with FEV1/FVC％(all rs＜0.6,P＞0.001),and were strongly positively correlated with FEV1％pred(all rs＞0.6,P＜0.001).Conclusion The aggravation of pulmonary function impairment in COPD patients,especially the severity and above level,can lead to the decrease of bone density.
基金项目
河北省政府资助临床医学优秀人才培养项目(ZF2023009)
NETL
NSTL
万方数据