目的 探讨基于CT定量分析的肺 小血管与肺截面积比值(%CSA)与慢性阻 塞性肺疾病(COPD)患者肺功能指标的相 关性。方法 回顾性分析80例行CT胸部 平扫的COPD患者及40名正常对照者的资 料。所有COPD患者均行肺功能检查，并根 据肺功能指标将COPD患者分为轻度组(26 例)、中度组(27例)、重度组(27例)3个 亚组。采用ImageJ图像后处理软件测量 基于CT下的%CSA(肺小血管的截面积<5mm2 和5-10mm2 分别标记为%CSA<5和%CSA5-10) 数据。采用单因素方差分析比较COPD各 亚组间及其与对照组的%CSA<5、%CSA5-10 以及肺功能指标，采用Spearman相关分 析%CSA<5和%CSA5-10与肺功能指标的相关 性。结果 COPD轻度组、中度组以及重度 组的%CSA<5，显著低于对照组，差异有 统计学意义(P<0.05)，且不同程度COPD 患者之间的%CSA<5值均存在显著性差异 (P<0.05)；COPD中度组、重度组的%CSA5- 10，显著低于对照组和轻度组，差异有统 计学意义(P<0.05)；COPD患者的%CSA<5 与FEV1%、FEV1/FVC%呈显著正相关 (r=0.982，0.988 P=0.018，0.012)，与 RV和RV/TLC%呈显著负相关(r=-0.946，- 0.962 P =0.044，0.028)；COPD患者 的%CSA5-10与FEV1%、FEV1/FVC%呈显 著正相关(r=0.963，0.975 P=0.037， 0.025)，与FVC、RV和RV/TLC%无显著相 关性。结论 基于CT定量分析的%CSA<5 和%CSA5-10与COPD患者的肺功能有一定的 相关性，且在评估COPD患者肺功能及疾病 严重程度方面%CSA<5优于%CSA5-10。

Objective The relationship between the percentage of the total cross-sectional area (%CSA) of small pulmonary vessels for the lung area in MSCT and pulmonary function test(PET) in chronic obstructive pulmonary disease(COPD). Methods 80 COPD patients and 40 normal subjects underwent chest MSCT scans and all clinic data were analyzed retrospectively. All COPD patientsunderwentPFT were classified into mild group (n=26), moderate group (n=27), severe group (n=27) according to PET resultsrespectively. The %CSA<5 mm2 and 5-10 mm2 for the lung area (called % CSA<5 and % CSA5-10) of small pulmonary vessels were measured with Image J image-processing program. Comparison between the COPD subgroups and control group were carriedout with ANOVA test. The relationship between %CSAand PFT results was carriedout with the Spearman rankcorrelation test. Results The % CSA<5 in mild, moderate and severe COPD group were (0.68±0.11)%, (0.56±0.12)%, (0.42±0.10)%, which were lower than that in control group (0.84±0.13)%, and the difference were statistically significant (P<0.05). The difference were statistically significant among the COPD subgroups(P<0.05). The % CSA5-10 in moderate and severe COPD group were (0.19±0.09)%, (0.18±0.06)%, which were lower than that in control and mild group [(0.32±0.14)%,(0.28±0.08)%], and the difference were statistically significant (P<0.05). %CSA<5 in COPD patients correlatedpositively with both FEV1% and FEV1/FVC(r=0.982,0.988 P=0.018,0.012), and negatively with both RV and RV/TLC%(r=-0.946,-0.962 P=0.044,0.028). %CSA5-10in COPD patients correlatedpositively with both FEV1% and FEV1/ FVC(r=0.963,0. 0.975 P=0.037,0.025), and no correlation with RV and RV/TLC%. Conclusion The measurement of %CSA<5 and %CSA5-10 in MSCT images were correlated with PFTs, and %CSA<5 was better than %CSA5-10 which may play the role in evaluating the PFTs and severity of COPD patients.