在CT胸部的肺血管特征与COPD基因中吸烟者的不良结果有不同的关联
Shelsey W Johnson1, Pietro Nardelli2, James C Ross3
1Brigham and Women's Hospital, Pulmonary , Boston, Massachusetts, United States; swjohnson@mgb.org.
肺动脉与大动脉的比率 (PA/Ao) 与COPD患者的急性呼吸事件有关. 远端肺动脉修剪与吸烟者的死亡率有关,有或没有COPD.
科学领域:
- 肺血管疾病成像成像 肺血管疾病成像
- 慢性阻塞性肺病 (COPD) 是一种慢性阻塞性肺病.
- 心肺CT成像分析分析
背景情况:
- 基于胸部计算机断层扫描 (CT) 的肺血管疾病指标与COPD和无COPD吸烟者的不良结果之间的关联尚未得到充分理解.
- 肺血管疾病是COPD已知的并发症,也是死亡率的预测因素.
研究的目的:
- 量化CT衍生的肺和心血管特征与急性呼吸道事件 (ARE) 和COPD和无COPD吸烟者的死亡率的差异关联.
- 为了研究CT成像标志物从远端肺动脉到中央大血管和心脏腔室.
主要方法:
- 利用了COPDGene研究的数据,包括患有COPD和没有COPD的吸烟者.
- 采用负双项和多变量Cox比例危险模型来评估CT特征 (例如,遥远的肺动脉修剪,前动脉扩张,PA/Ao比率,RV/LV比率) 和它们与结果的关联.
- 卡普兰-梅尔曲线被用来评估与修剪相关的死亡风险.
主要成果:
- 分析包括3169名患有COPD的吸烟者和2530名没有COPD的吸烟者.
- 在患有COPD的吸烟者中,肺动脉与大动脉 (PA/Ao) 的比率与ARE (IRR1.08,95% CI1.04-1.12) 有意义地相关,独立于远端血管.
- 肺动脉修剪显示,在有 (HR 1.26,95% CI 1.11-1.42) 和没有COPD (HR 1.22,95% CI 1.14-1.30) 的吸烟者中,与死亡率的关联最强.
结论:
- 肺动脉修剪是吸烟者死亡风险的重要预测因素,不管COPD状态如何.
- PA/Ao比率可以选择性地预测COPD患者的ARE,即使考虑到远端肺血管变化.
- 在患有COPD的吸烟者和没有COPD但有显著肺气的吸烟者中,发现了前膜扩张和死亡率之间的新兴关联.
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