采用支气管内光学相干断层扫描测量不同分期COPD患者的气道重塑

Measuring Airway Remodeling in Patients With Different COPD Staging Using Endobronchial Optical Coherence Tomography
2017-03-15 16:04发表评论
作者:Ding, M., Chen, Y., Guan, W.-J., Zhong, C.-H., Jiang, M., Luo, W.-Z., Chen, X.-B., Tang, C.-L., Tang, Y., Jian, Q.-M., Wang, W., Li, S.-Y. , Zhong, N.-S.
机构: 广州医科大学附属第一医院呼吸疾病研究所
期刊: CHEST2016年12月6期150卷

Background Although FEV1 remains the gold standard for staging COPD, the association between airway remodeling and airflow limitation remains unclear. Endobronchial optical coherence tomography (EB-OCT) was performed to assess the association between disorders of large and medium to small airways and COPD staging. We also evaluated small airway architecture in heavy smokers with normal FEV1 (SNL) and healthy never-smokers. Methods We recruited 48 patients with COPD (stage I, n = 14; stage II, n = 15; stage, III-IV, n = 19), 21 SNL, and 17 healthy never-smokers. A smoking history inquiry, as well as spirometry, chest CT, bronchoscopy, and EB-OCT were performed. Mean luminal diameter (Dmean), inner luminal area (Ai), and airway wall area (Aw) of third- to ninth-generation bronchi were measured using EB-OCT. Results Patients with more advanced COPD demonstrated greater abnormality of airway architecture in both large and medium to small airways, followed by SNL and never-smokers. Abnormality of airway architecture and EB-OCT parameters in SNL were comparable to those in stage I COPD. FEV1% predicted correlated with Dmean and Ai of seventh- to ninth-generation bronchi in COPD; however, neither Dmean nor Ai of third- to sixth-generation bronchi correlated with FEV1% in stage I and stage II COPD and in SNL. Conclusions FEV1-based COPD staging partially correlates with small airway disorders in stage II-IV COPD. Small airway abnormalities detected by EB-OCT correlate with FEV1-based staging in COPD and identify early pathologic changes in healthy heavy smokers. © 2016 American College of Chest Physicians

通讯机构:State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
学科代码:心血管病学 呼吸病学 外科学   关键词:支气管内光学相干断层 COPD患者 气道重塑 ,中国作者重要发表 爱思唯尔医学网, Elseviermed
来源: Scopus
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