Evaluation And Diagnostic Efficacy Of Pulmonary Function In COPD Based On Quantitative CT And Laboratory Indexes

Objective To investigate the value of multilayer spiral CT in the diagnosis and severity gr ading of COPD,to analyze the correlation between quantitative CT parameters and pulmon ary function indexes,and to compare the blood eosinophil,neutrophil/lymphocyte ratio,pla telet/lymphocyte ratio and C-reactive protein levels between COPD patients and non-COP D patients.Methods 98 COPD patients and 78 non-COPD patients without underlying lung disease fr om other departments who attended the respiratory department of the Affiliated Hospital of North China University of Technology from September 2019 to June 2021 were selected f or MSCT,pulmonary function tests,routine blood tests and C-reactive protein tests.Patient s were classified into 4 degrees of mild,moderate,severe and very severe according to the COPD GOLD2020,and the lungs were analyzed and measured using post-processing softw are for the total percentage of the lung less than-950 HU LAA%,in the volume of both lun gs,the LAA%of each lung lobe,and the total lung volume and the volume of each lung lo be,and by identifying the bronchial tree and measuring the RB1 bronchi and the LB10 bro nchi and their associated pulmonary arteries were measured by identifying the bronchial tre e,including WA%,WT,and TDR and D of the bronchial artery accompanying the bronchu s.Quantitative CT parameters,pulmonary function parameters and laboratory parameters w ere compared between COPD and non-COPD groups,and quantitative CT parameters were compared between COPD groups.The ROC curves of each parameter were plotted,and th e diagnostic efficacy of quantitative CT indexes in evaluating the severity grading of emph ysema-type COPD was evaluated using pulmonary function tests as the gold standard.The correlation between quantitative CT indexes and pulmonary function indexes,as well as th e correlation between FEV₁ and BMI and each laboratory test index were also analyzed.Co unt data were expressed as rates,and the chi-square test was applied to analyze them.The Kolmogorov-Smirnov test was applied to test whether the measurement data obeyed norma l distribution,and for data that obeyed normal distribution,they were expressed byx±s,th e independent samples t-test or one-way ANOVA was used for statistical analysis;for data that did not obey normal distribution,they were expressed by median quartile spacing[M（Q R）],and the Mann-Whitney U test was used for statistical analysis.The lung function test r esults were used as the gold standard to plot the ROC curve,calculate the AUC,and calcul ate the Jorden index,cutoff value,sensitivity and specificity.Correlation studies were perfo rmed using Pearson correlation.Results 1 General data:The differences in age and gender between the COPD and non-CO PD groups were not statistically significant（χ²=3.434、t=-1.670,P>0.05）;the differences i n smoking,BMI and laboratory indexes EOS,NLR,PLR and CRP between the two groups were statistically significant（χ²=7.277、t=4.355、-17.267、-20.795、-38.066、-22.395,P<0.05）.2 Comparison of quantitative CT indexes and pulmonary function indexes:The di fferences in quantitative CT indexes and pulmonary function indexes between the COPD a nd non-COPD groups were statistically significant（all P<0.05）.3 Quantitative CT assessme nt results:the CT quantitative parameters total lung LAA%,bronchial RB1 and bronchial L B10 were all useful for assessing COPD,especially total LAA%and RB1-WA%in both lu ngs were more favorable for the The cut-off values of the two-lung total LAA%and RB1-WA%were 1.65%and 68.95%,respectively,with sensitivities of 85.7%and 82.7%,and sp ecificities of 98.7%and 92.7%,respectively.4 Correlation analysis between quantitative C T indicators and pulmonary function indicators:for COPD patients,the correlation between quantitative indicators measured by CT and pulmonary（P<0.05）.5 Correlation analysis bet ween FEV₁ and clinical indicators in the COPD group:the laboratory indicators EOS,NLR,PLR and CRP were elevated in the COPD group and were negatively correlated with FEV₁,while BMI was reduced in the COPD group and was positively correlated with FEV₁.Conclusion 1 Quantitative CT can be used for the diagnosis of COPD,in which the CT qu antitative parameters total lung LAA%,bronchial RB1 and bronchial LB10 quantitative par ameters WA%,WT,TDR,D can be used to assess COPD,especially the two lung total LA A%and RB1-WA%are more beneficial for grading the severity of emphysema phenotype COPD.The diagnostic efficacy of the two-lung total LAA%is the greatest.2 In patients wit h COPD,there is a correlation between quantitative indicators measured by CT and pulmon ary function indicators,in which the lung volume measured by CT can be used to assess th e actual lung volume.3 EOS,NLR,PLR,CRP,and BMI may be clinical indicators that affe ct COPD patients.Figure13;Table14;Reference159...