Correlation Between CT Pulmonary Vascular Parameters And Severity In Patients With Acute Exacerbation Of COPD

Objective:To explore the relationship between pulmonary vascular parameters in chest high-resolution CT(HRCT)and clinical severity in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:Collected 60 cases'clinical data of AECOPD patients between January 2016 and January 2018,including vital signs,arterial blood gas analysis,number of acute exacerbations in the previous year and chest HRCT image data during admission.It is divided into mild(no respiratory failure),moderate(acute respiratory failure-no life danger)and severe group(acute respiratory failure-life danger)according to its clinical and arterial blood gas analysis.It is divided into two groups of frequent acute exacerbation(?2 time/year)and nonfrequent acute exacerbation(<2 times/year)according to that acute exacerbation times in the previous year.Measurement of chest HRCT cross-sectional area of small pulmonary vessels<5mm~2 as a percentage of total lung area(%CSA<5),and ratio of the diameter of the pulmonary artery to that of the aorta(PA/A),analysis%CSA<5 and PA/A differences of each group,and comparison of pulmonary vascular parameters in chest HRCT between different acute exacerbation frequencies groups,and analysis of%CSA<5 of AECOPD patients with PA/A and clinical indicators.Results:(1)General information There are 20 cases in each group of mild,moderate and severe,and no significant difference in gender,age and smoking index between the three groups.(2)The difference of%CSA<5 between the three groups was statistically significant(F=5.918,P<0.05),%CSA<5 of severe group[(0.54+0.14)%]was significantly less than mild[(0.68+0.16)%]and moderate group[(0.67+0.13)%](t=3.031?2.978,P<0.05).No statistically significant difference in PA/A between the three groups(F=2.560,P>0.05).Compared with nonfrequent acute exacerbation group[(0.69+0.16)%],%CSA<5 of frequent acute exacerbation group[(0.58±0.13)%]decreased significantly,the difference was statistically significant(t=2.881,P=0.006).(3)%CSA<5 of AECOPD patients was significantly positively correlated with arterial PH value and oxygen partial pressure,and significantly negatively correlated with acute exacerbation frequency,carbon dioxide partial pressure and PA/A(r=0.372?0.328?-0.363?-0.342?-0.323,all P<0.05).ConclusionsThe cross sectional area of small pulmonary vessels in chest HRCT was significantly decreased in patients of severe and frequent acute exacerbation AECOPD.Suggest that%CSA<5 may be an effective indicator to assess the clinical severity of COPD and play a significant guiding role in the diagnosis and treatment during the acute exacerbation of COPD.