肺功能下降的结构预测者在年轻吸烟者与正常的螺旋计.
Andrew I Ritchie1,2, Gavin C Donaldson1, Eric A Hoffman3,4
1National Heart and Lung Institute, Imperial College London, London, United Kingdom.
American journal of respiratory and critical care medicine
|January 4, 2024
概括
吸烟者的早期肺损伤可以通过CT扫描检测到,即使肺功能正常. 这些结构变化预测慢性阻塞性肺病 (COPD) 的未来肺功能下降.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
- 呼吸系统健康 呼吸系统健康
背景情况:
- 慢性阻塞性肺病 (COPD) 通常在严重的肺损伤后被诊断出来.
- 早期发现吸烟者的结构变化对于了解COPD进展至关重要.
研究的目的:
- 用定量计算断层扫描 (QCT) 来调查吸烟者的肺部早期结构变化.
- 为了确定这些早期的结构变化是否与随着时间的推移肺功能下降相关.
主要方法:
- 招募了431名当前吸烟者和67名非吸烟者对照.
- 在基线使用了COPD评估测试 (CAT),螺旋计和QCT扫描.
- 对368名参与者进行了平均32个月的跟踪,以评估FEV1的下降.
主要成果:
- 与对照人群相比,吸烟者显示小气道疾病的QCT标志物增加,地面玻璃变暗,血管结构发生变化.
- 这些QCT异常,以及较高的CAT得分,与更快的FEV1下降有关.
- 在年轻吸烟者中存在放射性异常,最初肺功能正常.
结论:
- 结构性肺部异常在吸烟者中是可以早期检测到的,在显著的肺功能丧失之前.
- QCT的发现是早期COPDFEV1下降的独立预测因素.
- 早期的放射性变化是吸烟者中COPD进展的标志物.
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