The High Resolution Computed Tomography in Assessment of Patients with Emphysema Following Smoking Cessation

肺氣腫患者戒菸後的高解析度電腦斷層掃描評估

陳珠珠(Tin-Myo Hlaing) ； 王貞云(Sophie Yu Wang) ； 陳世民(Shih-Min Chen) ； 王正信(Jeng-Shing Wang)

《內科學誌》 26卷2期 (2015/04) Pp. 107-114

https://doi.org/10.6314/JIMT.2015.26(2).06

摘要

本研究的目的是評估胸部高解析度電腦斷層掃描（HRCT）－診斷肺氣腫受試者戒菸後的短期效應變化，無論是橫斷面和縱斷面，重複使用HRCT掃描。進行詳細臨床病史和體格檢查。我們進行血清研究，肺功能測試和HRCT掃描，以評估肺氣腫。所有患者參加為期3月戒菸計畫。參與戒菸之後，身體質量指數顯著增加（0.88千克／平方米，P ＜0.001）。第一秒用力呼氣容積顯著下降（3.0%（33ml），P ＜0.001），但小於抽菸者的下降。還有C反應蛋白顯著下降（0.40 毫克／L，P＜0.001）及聖喬治呼吸問卷顯著下降（21，P ＜0.001）。圖像方面，平均肺密度和衰減值分開至少15%的像素顯著下降（7.7 HU，P ＜0.001），但衰減值百分比＜-950 亨氏單位的肺部的相對面積顯著增加（1.9%，P ＜0.001）。吸煙，modified Medical Research Councilscale，ADO指標，DOSE指標（P均＜0.001），和急性發作顯著下降（P ＜0.01），但肺氣腫的嚴重程度顯著增加（P＜0.05）。本研究顯示肺氣腫患者戒菸後的高解析度電腦斷層掃描評估的可能重要的變化。

並列摘要

The purpose of our study was to evaluate the short-term effect of changes in smoking cessation on subjects with chest high resolution computed tomography (HRCT)-diagnosed emphysema, both crosssectionally and longitudinally. All patients participated in 3 months smoking cessation program.A detailed clinical history was taken and physical examination performed. We performed serum study, lung function testing and HRCT scanning to assess emphysema. After participation in the program, there was a significant increment in body mass index (0.88 kg/m2, p ＜ 0.001). There was a significant decline in forced expiratory volume in one second (3.0 % (33 ml), p ＜ 0.001), but smaller than decline in smokers. There was also a significant decline in C-reactive protein (0.40 mg/L, p ＜ 0.001) & St. George’s Respiratory Questionnaire (21, p ＜ 0.001). In CT image, there were significant decreases in mean lung density and the attenuation value separating the least 15% pixels (7.7 HU, p ＜ 0.001), but a significant increase in the percentage of the relative area of the lungs with attenuation values ＜ -950 Hounsfield unit (1.9%, p ＜ 0.001). There were significant declines in smoking, modified Medical Research Council scale, Age-Dyspnea-Obstruction (ADO) index, Dyspnea-Obstruction-Smoking-Exacerbation (DOSE) index (all p ＜ 0.001), and exacerbation (p ＜ 0.01), but a significant increase in emphysema severity (p ＜ 0.05). This study shows the possible important change of HRCT in patients with emphysema following smoking cessation.

並列關鍵字

Emphysema ； High resolution computed tomography ； Mean lung density ； Percentile ； Relative area ； Smoking cessation