Study On The Imaging Features Of Chronic Obstructive Pulmonary Disease And The Correlation With Cardiopulmonary Function

Objective The aim of the study is to explore the lung morphological changes of different grade of chronic obstructive pulmonary disease(COPD)and the cardiac morphological changes and cardiac function,to analyze the relationship between morphological changes and pulmonary function as well as heart function.That might provide reference for the clinical diagnosis and treatment of COPD and pulmonary heart disease.Methods A total of 120 patients with stable COPD in Changyi people’s Hospital of Shandong province were selected,including 72 males and 48 females,aged 56-72 years.All cases were corresponded to diagnosis standards of COPD.Group was divided by lung function classification(GOLD classification).15 healthy adults were selected as normal control group.The pulmonary function test(PFT)and spiral CT(MSCT)examination,blood gas analysis,cardiac Doppler examination,MSCT image were used to analyze the levels in patients with COPD features and lung function relationship:FEV1(forced expiratory volume in 1 second),FEV1/FVC(Forced expiratory volume in the first second accounted for percentage of forced vital capacity),RV/TLC(Residual volume / total lung),VCMAX(maximum vital capacity),bronchial lumen area(measured by the lumen area were higher for bronchial branches opening at the next level because of the bronchial lumen was not circular,measured the transverse diameter and sagittal diameter,and then calculated the average of the branch diameter and the lumen area),Doppler detection and heart right atrial diameter(RA),right ventricular diastolic diameter(RVD),right ventricular anterior wall thickness(RVAW),interventricular septal thickness(IVSD),right ventricular end diastolic volume(RVEDV),right ventricular end systolic volume(RVESV),ejection fraction(EF),right pulmonary artery the diameter(RPAD),pulmonary artery pressure,PO2(Pa O2),PCO2(Pa CO2),p H value,and analyze the changes with the characteristics of pulmonary function.The experimental data were processed by SPSS18.0 statistical software.Results Pulmonary function was measured in 120 patients with COPD.With the decrease of lung function,FEV1 and FEV1/FVC gradually decreased,and RV/TLC increased gradually.With the decrease of lung function,the sectional area of left and right lung segments,sub segments and terminal bronchioles gradually increased.Double lobe(except the right lung section 9-10)leaves on the terminal bronchioles,right upper lobe and right lung(1-2)sub segmental bronchus,left and right lung the segmental bronchial cross-sectional area in pulmonary function of 1 level(t=2.91~7.58,P<0.01)significantly expanded,was early changes of parameters of the decline in lung function during the process;the upper lobe of the left lung terminal bronchiole cross-sectional area in the pulmonary function of 2 level significantly expand(t=2.68~9.53,P<0.01),which was the medium-term index of the decline in lung function.In the right middle lobe of the lung,the bronchial cross section of the terminal bronchioles,the inferior pulmonary lobes and the left upper lobe of the lung showed significant expansion in the 3grade of pulmonary function(t=2.14~4.95,P<0.05),which was the late index of pulmonary morphological changes during the course of pulmonary function decrease.With the decrease of lung function,the levels of RAD,RVD,RVAW,IVSD,RVEDV,RVESV,RPAD,pulmonary arterial pressure and PCO2 increased gradually(F=19.51~135.65,P<0.01),and PO2 and EF showed a decreasing trend(F=36.96~84.47,P<0.01).RVAW,IVSD,RVEDV,RVESV and EF showed significant changes in lung function level 1(t=2.10~19.16,P<0.01),an early indicator of changes in cardiac morphology changes of pulmonary function in the process of RAD,RVD,and RPAD,which also significant changes in lung function in the 3-4 level(t=5.09~7.01,P<0.01)for the middle and late stage index.Conclusions MSCT can be used to observe the changes of bronchial lumen volume at various levels and evaluate the lung function.The morphological changes of lung and heart were associated with the lung and heart function of COPD,with synchronization and spatiotemporal consistency.