Pulmonary functions and imaging features of patients with chronic obstructive pulmonary disease combined with mild carbon dioxide retention

doi:10.3877/cma.j.issn.1674-6902.2020.01.005

Abstract

Abstract:

Objective

To investigate the pulmonary functions and imaging features of the patients with chronic obstructive pulmonary disease (COPD) combined with mild carbon dioxide (CO₂) retention in order to provide evidences for monitoring and treatment of this disease.

Methods

A total of 147 patients with acute exacerbation of COPD were included for this study. Sixty-one patients with the arterial carbon dioxide tension (PaCO₂) of 40-44.9 mm Hg were taken as the no-CO₂ retention group, 48 patients with PaCO₂ of 45-50 mmHg were taken as the mild CO₂ retention group, and 38 cases with PaCO₂ of more than 50 mmHg were taken as the respiratory failure group. The differences of the pulmonary functions and volume CT were compared between the three groups.

Results

In the mild CO₂ retention group, the pulmonary function parameters such as the percentage of predicted forced expiratory volume in one second (FEV₁%pred), CT value corresponding to the 15th percentile of lung density distribution (PD15) and the mean emphysema density (MED) were significantly different from those of the respiratory failure group (P<0.05). Spearman correlation analysis showed that PaCO₂ had a moderate negative correlation with FEV₁%pred and the percentage of predicted forced vital capacity (FVC%pred, r=-0.536 and -0.576, respectively, P<0.001) and a weak negative correlation with PD15 of the whole lungs (r=-0.325, P=0.002) and the MED of the whole lungs (r=-0.333, P=0.002).

Conclusion

The structure and functional characteristics of the COPD patients with mild CO₂ retention are similar to the COPD patients with no CO₂ retention. The COPD patients with PaCO₂>50 mmHg suffer from more severe pathological and pulmonary function damage. In the progression of mild CO₂ retention to type Ⅱ respiratory failure, the pulmonary function parameters combined with PD15 and MED may better reflect the disease.

Key words: Chronic obstructive pulmonary disease, Carbon dioxide retention, Pulmonary function test, CT imaging

Xia Wei, Nan Yu, Jiuyun Mi, Jingting Ren, Qi Ding, Yanzhong Gao, Min Qi, Youmin Guo. Pulmonary functions and imaging features of patients with chronic obstructive pulmonary disease combined with mild carbon dioxide retention[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(01): 23-27.

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Figures/Tables 4

References 25

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肺气肿参数	例数	PD15_全肺	PD15_右肺	PD15_左肺	PD15_右上肺	PD15_右中肺	PD15_右下肺	PD15_左上肺	PD15_左下肺
非潴留组	61	-1 007.69±4.08	-1 007.39±4.29	-1 008.05±4.21	-1 006.82±4.37	-1 007.18±5.96	-1 007.36±4.63	-1 007.72±4.37	-1 008.2±4.6
轻度潴留组	48	-1 007.06±4.47^b	-1 006.65±4.79^b	-1 007.52±4.36^b	-1 006.69±5.75^a	-1 006.85±5.3^a	-1 006.42±5.37^a	-1 007.19±4.38^b	-1 007.81±4.72^a
呼衰组	38	-1 009.97±4.65^d	-1 009.53±5.01^d	-1 010.18±4.68^d	-1 009.21±5.6^d	-1 009.45±4.59^d	-1 009.21±5.06	-1 009.89±4.68^d	-1 010.18±4.95^d
F值		5.134	4.298	4.309	3.16	2.836	3.383	4.312	3.017
P值		0.007	0.015	0.015	0.045	0.062	0.037	0.015	0.052
肺气肿参数	例数	MED_全肺	MED_右肺	MED_左肺	MED_右上肺	MED_右中肺	MED_右下肺	MED_左上肺	MED_左下肺
非潴留组	61	-982.32±2.88	-982.04±2.94	-982.62±3.04	-981.8±3.02	-965.19±126.76	-982.03±3.14	-982.36±3.16	-982.54±3.1
轻度潴留组	48	-981.92±3.15^b	-981.69±3.37^b	-982.16±3.02^b	-981.51±3.59^a	-960.87±141.67	-981.43±3.64^a	-982±3.11^b	-982.18±3.24^a
呼衰组	38	-984.03±3.18^e	-983.7±3.31^d	-984.09±3.2^d	-983.33±3.69^d	-983.17±3.31	-983.2±3.3	-983.97±3.22^d	-983.78±3.19
F值		5.603	4.761	4.442	3.452	0.44	2.999	4.636	2.945
P值		0.005	0.01	0.013	0.034	0.645	0.053	0.011	0.056

肺气肿参数	例数	PD15_全肺	PD15_右肺	PD15_左肺	PD15_右上肺	PD15_右中肺	PD15_右下肺	PD15_左上肺	PD15_左下肺
非潴留组	61	-1 007.69±4.08	-1 007.39±4.29	-1 008.05±4.21	-1 006.82±4.37	-1 007.18±5.96	-1 007.36±4.63	-1 007.72±4.37	-1 008.2±4.6
轻度潴留组	48	-1 007.06±4.47^b	-1 006.65±4.79^b	-1 007.52±4.36^b	-1 006.69±5.75^a	-1 006.85±5.3^a	-1 006.42±5.37^a	-1 007.19±4.38^b	-1 007.81±4.72^a
呼衰组	38	-1 009.97±4.65^d	-1 009.53±5.01^d	-1 010.18±4.68^d	-1 009.21±5.6^d	-1 009.45±4.59^d	-1 009.21±5.06	-1 009.89±4.68^d	-1 010.18±4.95^d
F值		5.134	4.298	4.309	3.16	2.836	3.383	4.312	3.017
P值		0.007	0.015	0.015	0.045	0.062	0.037	0.015	0.052
肺气肿参数	例数	MED_全肺	MED_右肺	MED_左肺	MED_右上肺	MED_右中肺	MED_右下肺	MED_左上肺	MED_左下肺
非潴留组	61	-982.32±2.88	-982.04±2.94	-982.62±3.04	-981.8±3.02	-965.19±126.76	-982.03±3.14	-982.36±3.16	-982.54±3.1
轻度潴留组	48	-981.92±3.15^b	-981.69±3.37^b	-982.16±3.02^b	-981.51±3.59^a	-960.87±141.67	-981.43±3.64^a	-982±3.11^b	-982.18±3.24^a
呼衰组	38	-984.03±3.18^e	-983.7±3.31^d	-984.09±3.2^d	-983.33±3.69^d	-983.17±3.31	-983.2±3.3	-983.97±3.22^d	-983.78±3.19
F值		5.603	4.761	4.442	3.452	0.44	2.999	4.636	2.945
P值		0.005	0.01	0.013	0.034	0.645	0.053	0.011	0.056

肺功能	r	P值	PD15(Hu)	r	P值	MED(Hu)	相关系数	P值
MVV%pred	-0.451	<0.001	PD15_全肺	-0.325	0.002	MED_全肺	-0.333	0.002
FEV₁%	-0.536	<0.001	PD15_右肺	-0.317	0.003	MED_右肺	-0.327	0.002
FVC%Pred	-0.576	<0.001	PD15_左肺	-0.298	0.005	MED_左肺	-0.309	0.004
FEV₁/FVC	-0.273	0.011	PD15_右上肺	-0.281	0.009	MED_右上肺	-0.293	0.007
MMEF	-0.506	<0.001	PD15_右中肺	-0.305	0.004	MED_右中肺	-0.349	0.001
DLCO/VA	-0.277	0.011	PD15_右下肺	-0.288	0.007	MED_右下肺	-0.274	0.011
RV/TLC	0.386	<0.001	PD15_左上肺	-0.294	0.006	MED_左上肺	-0.308	0.004
			PD15_左下肺	-0.287	0.007	MED_左下肺	-0.295	0.006

肺功能	r	P值	PD15(Hu)	r	P值	MED(Hu)	相关系数	P值
MVV%pred	-0.451	<0.001	PD15_全肺	-0.325	0.002	MED_全肺	-0.333	0.002
FEV₁%	-0.536	<0.001	PD15_右肺	-0.317	0.003	MED_右肺	-0.327	0.002
FVC%Pred	-0.576	<0.001	PD15_左肺	-0.298	0.005	MED_左肺	-0.309	0.004
FEV₁/FVC	-0.273	0.011	PD15_右上肺	-0.281	0.009	MED_右上肺	-0.293	0.007
MMEF	-0.506	<0.001	PD15_右中肺	-0.305	0.004	MED_右中肺	-0.349	0.001
DLCO/VA	-0.277	0.011	PD15_右下肺	-0.288	0.007	MED_右下肺	-0.274	0.011
RV/TLC	0.386	<0.001	PD15_左上肺	-0.294	0.006	MED_左上肺	-0.308	0.004
			PD15_左下肺	-0.287	0.007	MED_左下肺	-0.295	0.006

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