探讨高分辨率CT(HRCT)测得的肺小血管截面积与肺截面积比值(%CSA)在评估慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)中的应用价值。

选择行HRCT胸部平扫的COPD合并PH 20例患者及20名正常对照组资料。所有检查中均行肺功能检查(PFT)，测得第1秒用力呼气容积实测值与预计值百分比(FEV1%)和FEV1与用力肺活量之比(FEV1/FVC)。测得基于HRCT的%CSA(肺小血管截面积<5 mm²和5～10 mm²分别为%CSA<5和%CSA5～10)数据。应用独立样本t检验比较COPD合并PH组与对照组间差异，采用Spearman相关分析COPD合并PH组%CSA与PFT指标之间的相关性。

COPD合并PH组和对照组的%CSA<5分别为(1.04±0.20)%、(0.82±0.14)%，差异有统计学意义(t＝4.07，P<0.01)。上述两组的%CSA5～10分别为(0.53±0.13)%、(0.33±0.08)%，差异有统计学意义(t＝5.41，P<0.01)。COPD合并PH组的FEV1%和FEV1/FVC分别为(32.40±11.31)%、(44.10±18.30)%。COPD合并PH组的%CSA<5与FEV1%和FEV1/FVC无相关性(r值分别为－0.136和－0.149，均P>0.05)。COPD合并PH组的%CSA5～10与FEV1%和FEV1/FVC无相关性(r值分别为－0.084和－0.072，均P>0.05)。

COPD合并PH患者的%CSA<5 mm²和%CSA5～10 mm²较正常升高，可作为一种反映COPD合并PH严重程度的指标。

To investigate the role of the percentage of the total cross-sectional area of small pulmonary vessels for the lung area (%CSA) from high resolution computed tomography(HRCT)in chronic obstructive pulmonary disease (COPD) combined pulmonary hypertension(PH).

Twenty COPD combined PH patients and 20 normal subjects underwent chest HRCT scans and all data were analyzed retrospectively.COPD combined PH patients underwent pulmonary function tests (PFT), including forced expiratory volume in one second (FEV1%) and FEV1/forced vital capacity (FEV1/FVC), respectively.The %CSA less than 5 mm² and 5~10 mm² for the lung area (%CSA<5 and %CSA5~10) of small pulmonary vessels were measured with HRCT.Comparison of %CSA<5 and %CSA5~10 between the COPD combined PH and control groups were performed using t test.The correlation between % CSA and PFT was evaluated by the Spearman rank correlation test.

%CSA<5 of COPD combined PH patients and control group were (1.04±0.20)%、(0.82±0.14)%, respectively, the difference was statistically significant.%CSA5-10 of the two groups were (0.53±0.13)%、(0.33±0.08)% the difference between the two groups was significant. (t=5.41, P<0.01). FEV1% and FEV1/FVC in COPD patients were(32.40±11.31)% and (44.10±18.30)%.%CSA<5 in COPD patients were not correlated negatively with both FEV1% and FEV1/FVC (r=-0.136, -0.149; P>0.05). %CSA5~10 in COPD patients were not correlated negatively with both FEV1% and FEV1/FVC (r=-0.084, -0.724; P>0.05).

%CSA<5 and %CSA5~10 of COPD combined PH patients are higher than those of normal, they can be used as an index reflecting the severity of COPD combined PH.