High-Resolution Computed Tomography Used to Assess Patients with Emphysema Following Pulmonary Rehabilitation

肺氣腫患者肺部復健後的高解析度電腦斷層掃描評估

陳世民(Shih-Min Chen) ； 王貞云(Sophie Yu Wang) ； 王正信(Jeng-Shing Wang)

《胸腔醫學》 30卷6期 (2015/12) Pp. 327-336

摘要

目的：本研究的目的是評估胸部高解析度電腦斷層掃描（HRCT）－診斷肺氣腫受試者肺部復健後的短期效應變化，無論是橫斷面和縱斷面，重複使用HRCT掃描。方法：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12週，門診為基礎的肺部復健，包括每週三節。結果：參與復健之後，身體質量指數顯著改善（0.55千克／平方米，p＜0.001）。第一秒用力呼氣容積顯著下降（0.60%，p＜0.001），但小於正常的下降。還有C反應蛋白顯著下降（0.20毫克／L，p＜0.001）及聖喬治呼吸問卷顯著下降（11，p＜0.001）。圖像方面，平均肺密度和衰減值分開至少15%的像素顯著增加（4.1 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下降（1.1%，p＜0.001）。吸煙（p＜0.01），其他急性發作，modified Medical Research Council scale，ADO指標，DOES指標和肺氣腫的嚴重程度皆顯著下降（p＜0.05）。結論：本研究顯示肺氣腫患者肺部復健後的高解析度電腦斷層掃描評估的可能重要的變化。

關鍵字

肺氣腫 ； 高解析度電腦斷層掃描 ； 平均肺密度 ； 百分 ； 相對面積 ； 肺部復健

並列摘要

Objectives: The purpose of our study was to evaluate the short-term effect of changes resulting from pulmonary rehabilitation on subjects with chest high-resolution computed tomography (HRCT)-diagnosed emphysema, both cross-sectionally and longitudinally, using repeated HRCT scans. Methods: A detailed clinical history was taken and physical examination performed. We performed a serum study, lung function testing and HRCT scanning to assess emphysema. All patients participated in 12-week, outpatient-based pulmonary rehabilitation consisting of 3 sessions per week. Results: After participating in the program, there was a significant improvement in the patients' body mass index (0.55 kg/m^2, p＜0.001), and a significant, but smaller than normal decline in forced expiratory volume in 1 second (0.60%, p＜0.001). There was also a significant decline in C-reactive protein (0.20 mg/L, p＜0.001) and St. George's Respiratory Questionnaire (11, p＜0.001). In the CT image, there were significant increases in mean lung density and attenuation value separating the lowest 15% of pixels (4.1 HU, p＜0.001), but a significant decrease in the percentage of the relative area of the lungs with attenuation values ＜ -950 Hounsfield unit (1.1%, p＜0.001). There were significant declines in smoking (p＜0.01), exacerbation, modified Medical Research Council scale, ADO index, DOES index, and emphysema severity (all p＜0.05). Conclusions: This study shows important changes in patients with emphysema assessed with HRCT following pulmonary rehabilitation.

並列關鍵字

emphysema ； high-resolution computed tomography ； mean lung density ； percentile ； relative area ； pulmonary rehabilitation