成人起病型嗜酸性哮喘患者的气道重塑与肺功能的相关性分析

Objective: To investigate the airway parameters of adult-onset eosinophilic asthma (EA) and analyze the correlation between airway remodeling and lung function by quantitative CT. Methods: From March 2015 to November 2016, totally 94 subjects from the "FACT-Digital Lung" Multi-research Center were divided into three groups: 30 normal subjects, 33 EA patients and 31 non-eosinophilic asthma (NEA) patients. We measured and recorded the bronchial parameters of RB1, LB1+2, RB10, and LB10, and small airway disease parameters. The indicators for quantitative evaluation of bronchial parameters include lumen area (LA), wall thickness (WT), wall area (WA), and wall area percentage (WA%). The parameters for the quantitative assessment of small airway disease included the percentage of inspiratory voxels below -950HU (IN_-950), the mean lung density (MLD_in), and the whole volume of the lung in inspiration (V_in). Pearson or Spearman rank correlation analysis was used to evaluate the correlation between these parameters and lung function. Results: The differences in LA/BSA, WT/√BSA, and WA/BSA between the three groups were statistically significant (P<0.05). FEV₁% had a significant correlation with IN_-950 and MLD_in (P<0.01). FEV₁/FVC had a significant correlation with V_in, IN_-950, and MLD_in (P<0.01). EOS counts were positively related to IN_-950 (r=0.343, P=0.011), while EOS had a negative correlation with FEV₁% (r=-0.343, P=0.015). Conclusion: With the increase of eosinophils counts in peripheral blood, the airway's stenosis in asthma patients gradually increased, and the extent of airflow limitation steadily increased. The IN_-950 may be a sensitive imaging biomarker for evaluating the small airway disease in adult-onset eosinophilic asthma patients.