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目的：探讨慢性阻塞性肺疾病(COPD) 螺旋CT 吸气相和呼气相扫描体积变化与血清细胞因子水平的内在关系。方法：记录 46 例符合纳入标准的COPD 患者的临床资料、缓解期的肺功能(FEV1%)，采用西门子16 排螺旋CT 对患者进行吸气相和呼气相扫描，计算吸气前后肺体积变化百分比。采用酶联免疫吸附法分别测定急性发作期和缓解期血浆可溶性细胞间粘附分子-1 (plasma soluble intercellular adhesion molecule-1, slCAM-1)和TNF-α（tumor necrosis factor-α）变化水平。对比分析肺功能、肺体积变化与细胞因子的相关性。结果：双相CT 扫描肺体积变化百分比为24.27 ± 9.82%，FEV1%平均值为53.50 ± 12.21%，血清 slCAM-1 和TNF-α 表达水平为166.58 ± 25.15 ng/ml、22.05 ± 4.36 pg/ml。COPD 肺功能、体积变化百分比与细胞因子表达存在负相关性，肺功能与肺体积变化存在正相关性(P<0.05)。结论：螺旋CT 双相扫描能准确反映COPD 肺体积的顺应性变化，与 slCAM-1 和TNF-α 表达水平都可作为判断COPD 肺功能及疗效的重要指标。

英文摘要:

Objective: To investigate the relationship between lung volume reduction score and cytokines of chronic obstructive pulmonary disease (COPD) using double-phase spiral CT scanning and Pulmo software. Methods: Forty-six patients with COPD were included in this study. The clinical data and pulmonary function of these patients were recorded. Double-phase CT scanning was performed using Siemens Emotion 16 spiral CT. Siemens Pulmo was used to calculate lung volume reduction score (LVRS). Plasma soluble intercellular adhesion molecule-1 (slCAM-1) and TNF-α were detected by ELISA. The difference and relationship between cytokines and LVRS of COPD in chronic stage were compared and analyzed. Results: The LVRS and FEV1% of COPD were 24.27 ± 9.82% and 53.50 ± 12.21%, respectively. The slCAM-1 and TNF-α of COPD were 166.58 ± 25.15 ng/ml and 22.05 ± 4. 36 pg/ml. Positive relationships were found between slCAM-1 and TNF-α (P<0.05). The levels of cytokines was related negatively with LVRS and FEV1% (P<0.05). Conclusion: Double-phase spiral CT scanning is useful to analyze the lung function quantitatively. The development of COPD was rela- ted closely with a variety of cytokines. slCAM-1 and TNF-α can be used as indicators in monitoring COPD.

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