| Purpose:To investigate the characteristics of lung function in patients with chronic obstructive pulmonary disease(COPD)Giant emphysematous bullae(GEB)and its correlation with disease severity.Method:The clinical data of 40 patients with GEB and chronic obstructive pulmonary disease(group A)and the other 40 patients with chronic obstructive pulmonary disease(group B)in People's Hospital of Hunan Province from September 2013 to February 2018 were retrospectively analyzed.Routine pulmonary ventilatory function tests were performed separately for the forced expiratory volume in one second(FEV1)and its percentage(FEV1%),while the lung function data of all patients were measured by single breath method and plethysmography for the residual volume(RV).total lung rapacity(TLC)and the percentages of both(RV%,TLC%),as well as the residual of residual volume to total lung capacity(RV/TLC).Besides,a questionnaire was conducted on the same day,which included ST.George' s respiratory questionnaire(SGRQ),modified British Medical Research Council days-dyspnea scale(mMRC),and an implementation of a 6-minute walking test(6MWT).In this way,differences of the above parameters between the two groups were compared to investigate the characteristics of lung function in patients with chronic obstructive pulmonary disease with GEB and its correlation with disease severity.To exclude the possibility of spontaneous pneumothorax in GEB patients caused by pulmonary function tests,GEB patients were examined for the severity of dyspnea after pulmonary function examination.Patients in GEB group underwent lung bullae puncture within 3 to 5 days,preoperative chest CT scan.result:1.Data of 40 patients with chronic obstructive pulmonary disease with GEB(group A,39 males and 1 female)and 40 patients with simple chronic obstructive pulmonary disease(group B,38 males and 2 fpmalps)were analyzed.There was no significant difference in age,height,weight,FEV1 and FEV1%between the two groups(P>0.05),and they were comparable.The RV%(237.83±65.84%),TLC%(122.78±23.10%),RV/TLC(72.24±10.51%)and SGRQ(54.73 ± 16.64)in group A were significantly higher than those in group B(RV%:200.33±47.87%,TLC%:104.35±22.58%,RV/TLC:67.20±8.26%,SGRQ:47.45±12.83).The 6MWT in group A(287.66±120.16m)was significantly lower than that in group B(338.66 ± 101.94m).There was no significant difference in mMRC between group A and B(P>0.05).2.There was a statistically significant difference in RV and TLC between the single breath method and the plethysmography(P<0.05).The RV(2.30±0.81L)and TLC(4.71± 1.07L)by single breath method measured in group A were greater than those in group B(RV:2.10±0.88L,TLC:4.21±1.16L).5.23±1.33L).The RV(5.23±1.33L)and TLC(7.20±1.27L)by plethysmography in group A were greater than those in group B(RV:4.14±0.69L,TLC:6.22±1.07L).3.(1)FEV1%in both groups(40 patients)were negatively correlated with SGRQ,mMRC(A:r=-0.933,-0.907,P<0.05;B:r=-0.869,-0.790,P<0.05),but represented positively correlated with 6WMT(A:r=0.953,P<0.05;B:r=0.883,P<0.05).(2)RV/LTC%in both groups(40 patients)were positively correlated with SGRQ and mMRC(A:r=0.688,0.676,P<0.05;B:r=0.399,0.325,P<0.05),but represented negatively correlated with 6WMT(A:r=-0.754,P<0.05;B:r=-0.555,P<0.05).(3)RV%in both A and B(40 patients)were positively correlated with SGRQ and mMRC(A:r=0.745,0.660,P<0.05;B:r=0.543,0.510,P<0.05),but represented negatively correlated with 6WMT(A:r=-0.754,P<0.05;B:r=-0.555,P<0.05).(4)In group A(40 cases),TLC%was positively correlated with SGRQ and mMRC(r=0.382,0.315,P<0.05),and negatively correlated with 6WMT(r=-0.415,P<0.05).There was no significant correlation between TLC%and SGRQ,mMRC and 6WMT in group B(P>0.05).4.(1)GOLD1~2 interval:RV%,TLC%,RV/TLC and FEV1%in group A and B(10 patients)were not correlated(P>0.05).(2)GOLD 3~4 interval:In group A(30 patients),RV%,TLC%and RV/TLC were negatively correlated with FEV1%(P<0.05,r=-0.782,-0.364,-0.364),while there was a negative correlation between RV%,RV/TLC and FEV1%in group B(P<0.05,r=-0.680,-0.543).However,there was no significant correlation between TLC%and FEV1%(P>0.05).5.(1)The symptoms of dyspnea were not aggravated after pulmonary function tests in group A.(2)Patients in group A underwent bullous puncture within 3 to 5 days,and chest CT scan before operation.No pneumothorax was found.Conclusion:1.RV,TLC,RV%,TLC%and RV/TLC were plainly increasing among patients with simple chronic obstructive pulmonarydisease,and the increasing would be more obvious with GEB,2.The quality of life and health status of chronicobstructive pulmonary disease patients with GEB were signi-ficantly lower than those with simple chronic obstructivepulmonary disease.The increasing of lung capacity index suchas RV?TLC?RV%?TLC%and RV/TLC might be one of those reasonswhy there were lower quality of life and health status ofchronic obstructive pulmonary disease patients with GEB.3.FEV1%,RV%,TLC%and RV/TLC were deduced to have a certain correlation with the quality of life and health status of chronic obstructive pulmonary disease patients with giant lung bullae,with FEV1%and RV%being the highest two among those parameters.4.It was relatively safe for patients with GEB to implement pulmonary function tests. |
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