小气道功能障碍可能是早期哮喘的预测指标：来自高分辨率CT的研究发现
2019/06/05
摘要
背景：哮喘中小气道的作用目前备受关注。小气道功能障碍型哮喘患者的第1秒用力肺活量通常正常，但伴有不成比例的小气道功能障碍。
目的：此研究的目的是确定小气道功能障碍型哮喘患者是否存在大气道的结构改变。
方法：对9例小气道功能障碍型哮喘患者及20例健康人行高分辨率CT（HRCT）扫描。在HRCT图像中找到左肺上叶尖后段（LB1+2）及左肺下叶基底段（LB10）的支气管。测量并比较小气道功能障碍型哮喘患者及健康人的第2～6级支气管的管腔面积（LA）、管壁面积（WA）及管壁面积的百分比（WA%）。
结果:小气道功能障碍型哮喘患者的第6级支气管的WA%较健康人明显升高（LB1 +2, P =.040; LB10, P=.033）。
结论：小气道功能障碍型哮喘患者出现大气道结构性改变可能代表哮喘的早期。
Small airway dysfunction may be an indicator of early asthma: findings from high-resolution CT.
Jiang D, Wang Z, Shen C, Jin C, Yu N, Wang J, Yin N, Guo Y
Abstract
BACKGROUND:Increasing attention is now focused on the role of the small airways in asthma. Patients with small airway asthma typically have a preserved forced expiratory volume in 1 second, with disproportionate small airway dysfunction.
OBJECTIVE:The aim of this study was to determine whether there are structural changes in the large airways in patients with small airway asthma.
METHODS:Nine patients with small airway asthma and 20 healthy controls underwent high-resolution computed tomography (HRCT) scan. The apicoposterior segmental bronchus in the left upper lobe (LB1+2) and the posterior basal segmental bronchus in the left lower lobe (LB10) were identified on HRCT images. The luminal area (LA), wall area (WA), and wall area percentage (WA%) of each bronchus were measured from the 2nd (lobar) to the 6th generation and compared between the patients with small airway asthma and the healthy controls.
RESULTS:The WA% of the 6th generation in the patients with small airway asthma was higher than that in the healthy controls; the difference was statistically significant (LB1 + 2, P = .040; LB10, P = .033).
CONCLUSION:Structural changes in the large airways of patients with small airway asthma may represent an early stage of asthma.
背景：哮喘中小气道的作用目前备受关注。小气道功能障碍型哮喘患者的第1秒用力肺活量通常正常，但伴有不成比例的小气道功能障碍。
目的：此研究的目的是确定小气道功能障碍型哮喘患者是否存在大气道的结构改变。
方法：对9例小气道功能障碍型哮喘患者及20例健康人行高分辨率CT（HRCT）扫描。在HRCT图像中找到左肺上叶尖后段（LB1+2）及左肺下叶基底段（LB10）的支气管。测量并比较小气道功能障碍型哮喘患者及健康人的第2～6级支气管的管腔面积（LA）、管壁面积（WA）及管壁面积的百分比（WA%）。
结果:小气道功能障碍型哮喘患者的第6级支气管的WA%较健康人明显升高（LB1 +2, P =.040; LB10, P=.033）。
结论：小气道功能障碍型哮喘患者出现大气道结构性改变可能代表哮喘的早期。
（上海交通大学附属第一人民医院呼吸与危重症医学科 张旻）
（Ann Allergy Asthma Immunol. 2019.122(5):498-501. doi: 10.1016/j.anai.2019.02.024.）
（Ann Allergy Asthma Immunol. 2019.122(5):498-501. doi: 10.1016/j.anai.2019.02.024.）
Small airway dysfunction may be an indicator of early asthma: findings from high-resolution CT.
Jiang D, Wang Z, Shen C, Jin C, Yu N, Wang J, Yin N, Guo Y
Abstract
BACKGROUND:Increasing attention is now focused on the role of the small airways in asthma. Patients with small airway asthma typically have a preserved forced expiratory volume in 1 second, with disproportionate small airway dysfunction.
OBJECTIVE:The aim of this study was to determine whether there are structural changes in the large airways in patients with small airway asthma.
METHODS:Nine patients with small airway asthma and 20 healthy controls underwent high-resolution computed tomography (HRCT) scan. The apicoposterior segmental bronchus in the left upper lobe (LB1+2) and the posterior basal segmental bronchus in the left lower lobe (LB10) were identified on HRCT images. The luminal area (LA), wall area (WA), and wall area percentage (WA%) of each bronchus were measured from the 2nd (lobar) to the 6th generation and compared between the patients with small airway asthma and the healthy controls.
RESULTS:The WA% of the 6th generation in the patients with small airway asthma was higher than that in the healthy controls; the difference was statistically significant (LB1 + 2, P = .040; LB10, P = .033).
CONCLUSION:Structural changes in the large airways of patients with small airway asthma may represent an early stage of asthma.
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