Quantitative Analysis Of Cross Sectional Area Between Thoracic Skeletal Muscles By CT And Its Correlation With Chronic Obstructive Pulmonary Disease

Objective:Quantitative CT analysis was used to explore the correlation between the cross-sectional area of thoracic muscle,erector spine muscle and intercostal muscle of COPD and the severity of the disease,so as to guide the early clinical intervention of COPD.Methods:Collect the physical examination center and breath of Jiujiang Third People’s Hospital from January 2020 to December 2022 the department diagnosed 267 COPD patients and excluded 54(14 interstitial pneumonia,5 asthma,6 cases of bronchiectasis,26 cases of pulmonary tuberculosis,15 cases of malignant tumor in the chest,and 6 cases of lobectomy caused by pulmonary surgery);Finally,105 healthy controls and 108 patients with COPD were enrolled in the study.The subjects were divided into three groups: healthy control group,mild to moderate group,severe to severe group,and all the participants had lung function and chest CT examination;According to the GOLD classification in 2018,COPD patients are divided into mild to moderate group(GOLD 1,GOLD 2),severe to severe group(GOLD 3,GOLD 4);All subjects quantitatively analyzed the cross-sectional areas of their pectoral muscles,erector spinal muscles and intercostal muscles based on CT,and the general sociological data of each group were different;Comparison of pulmonary function between healthy control group and COPD group;The cross-sectional areas of pectoral muscle,erector spinal muscle and intercostal muscle in COPD group were compared;To determine the correlation between the cross-sectional area of pectoral muscle,erector spinal muscle,intercostal muscle and pulmonary function and correlation of the m MRC score;The key factors influencing the severity of COPD patients were analyzed by logistic regression.Results:The subjects were divided into three groups: healthy control group,mild moderate group and severe extreme severe group.Statistical analysis of the general sociological data of the three groups of subjects showed that there were overall differences in age,smoking index and gender distribution among the three groups of subjects,and the differences were statistically significant(P<0.05).In terms of age distribution,the age of the healthy control group was lower than that of the mild moderate group,and the difference was statistically significant(P<0.05);meanwhile,the age of the healthy control group was also lower than that of the severe and extremely severe group,and the difference was statistically significant(P<0.05).In terms of smoking index,both the mild moderate group and the severe extremely severe group were larger than the healthy control group,and the difference was statistically significant(P<0.05).In terms of gender distribution,the proportion of men in both the mild to moderate and extremely severe groups was greater than that in the control group,and the difference was statistically significant(P <0.05).The three groups of subjects had statistically significant differences in pectoral muscle,erector spinal muscle and intercostal muscle(P<0.05).The cross-sectional area of the healthy control group in pectoral muscle,erector spinal muscle and intercostal muscle was larger than that in the mild moderate group and severe extreme severe group,and the difference was statistically significant(P<0.05).However,there was no significant difference in cross-sectional area of pectoral muscle,erector spinal muscle and intercostal muscle between mild moderate group and severe extreme severe group(P>0.05).The m MRC score was negatively correlated with the area of pectoral muscle,erector spinal muscle and intercostal muscle,and there was statistical significance(P<0.05).However,FEV1(%),FVC(%),FEV1/FVC(%)and finger pulse oxygen were positively correlated with the areas of pectoralis,erector spinae and intercostal muscles,and the difference was statistically significant(P<0.05).Patients’ age,sex,BMI,m MRC score,finger pulse oxygen,thoracic muscle,erector spinus muscle and intercostal muscle cross-sectional area were first included in univariate analysis.As can be seen from the data,age,gender,smoking index,and m MRC score were positively correlated with patients with severe and extremely severe COPD,while finger pulse oxygen,chest muscle,and intercostal muscle cross-sectional area were negatively correlated with patients with severe and extremely severe COPD.It can be seen that the cross-sectional area of pectoral muscle and intercostal muscle are key factors related to the severity of COPD patients.Conclusion:All patients with COPD have varying degrees of skeletal muscle atrophy,and the cross-sectional area of thoracic,erectus and intercostal muscles in COPD patients can be used to evaluate lung function and degree of dyspnea to a certain extent,and the cross-sectional area of thoracic and intercostal muscles is a key factor related to the severity of COPD patients.