慢性阻塞性肺疾病患者HRCT定量指标与肺功能的相关性研究

doi:10.11958/20221162

天津医药 ›› 2023, Vol. 51 ›› Issue (3): 320-324.doi: 10.11958/20221162

慢性阻塞性肺疾病患者HRCT定量指标与肺功能的相关性研究

张凤¹^,²(), 方著², 袁艺², 周芸慧², 张国晋², 蒲红¹^,^△(), 刘欢³

1 川北医学院（邮编610072）
2 四川省医学科学院·四川省人民医院·电子科技大学附属医院放射科
3 医疗精准医学研究院

收稿日期:2022-07-25 修回日期:2022-10-14 出版日期:2023-03-15 发布日期:2023-03-02
通讯作者: 蒲红 E-mail:1738018202@qq.com;ph196797@163.com
作者简介:张凤（1995），女，硕士在读，主要从事胸部影像方面研究。E-mail：1738018202@qq.com
基金资助:
四川省干部保健科研基金资助项目（川干研2022-208(川干研2022-208)

The correlation research of quantitative index of HRCT and lung function in patients with chronic obstructive pulmonary disease

ZHANG Feng¹^,²(), FANG Zhu², YUAN Yi², ZHOU Yunhui², ZHANG Guojin², PU Hong¹^,^△(), LIU Huan³

1 North Sichuan Medical College, Chengdu 610072, China
2 Department of Radiology, Sichuan Academy of Medical Sciences Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology of China
3 GE Healthcare

Received:2022-07-25 Revised:2022-10-14 Published:2023-03-15 Online:2023-03-02
Contact: PU Hong E-mail:1738018202@qq.com;ph196797@163.com

张凤, 方著, 袁艺, 周芸慧, 张国晋, 蒲红, 刘欢. 慢性阻塞性肺疾病患者HRCT定量指标与肺功能的相关性研究[J]. 天津医药, 2023, 51(3): 320-324.

ZHANG Feng, FANG Zhu, YUAN Yi, ZHOU Yunhui, ZHANG Guojin, PU Hong, LIU Huan. The correlation research of quantitative index of HRCT and lung function in patients with chronic obstructive pulmonary disease[J]. Tianjin Medical Journal, 2023, 51(3): 320-324.

摘要/Abstract

摘要： Objective To analyze quantitative indexes of emphysema and airway remodeling in patients with chronic obstructive pulmonary disease (COPD) by using high resolution CT (HRCT), and to explore the correlation between the above indexes and pulmonary function. Methods A total of 109 COPD patients (the COPD group) and 33 normal controls (the control group) were collected. According to the COPD Global Initiative guidelines, COPD patients were divided into the GOLD class Ⅰ group (n=29), the GOLD classⅡ group (n=38) and the GOLD class Ⅲ+Ⅳgroup (n=42). All patients underwent HRCT examination and pulmonary function examination. The post-processing software was used to automatically measure HRCT quantitative emphysema indexes of each lung lobe, including emphysema index (EI), mean lung density (MLD) of each lobe and airway quantitative indexes [bronchial wall area (WA), bronchial lumen area (LA) and the percentage of the wall area in the total bronchial section area (WA%)]. The above parameters were compared between the normal group and the different severity COPD subgroups. Spearman method was used to analyze the correlation between the above CT quantitative indexes and pulmonary function. Results Compared with the normal group, EI in upper lobe of both lungs was increased in the GOLD class Ⅰ group, EI in all lobes was increased in the GOLD class Ⅱ group, MLD values in upper lobe of both lungs and lower lobe of left lung were decreased, EI in all lobes was increased in the GOLD class Ⅲ+Ⅳ group, and MLD was decreased (P<0.05). Compared with the normal group, the WA of grade 5 bronchus and WA% of grade 4-6 bronchus were increased in the GOLD class Ⅰ group, and LA of grade 5 and 6 bronchus decreased. Compared with the GOLD class Ⅰ group, only WA and WA% of grade 6 bronchi were increased in the GOLD class Ⅱ group, and LA was decreased. Compared with the GOLD class Ⅱ group, WA% of grade 5 bronchial was decreased in the GOLD class Ⅲ+Ⅳ group (P<0.05). The measured and predicted percentages of forced expiratory volume in the first second (FEV1%) were negatively correlated with the EI of each lung lobe, and the MLD was positively correlated with FEV1% (P<0.01). The WA% of 5-6 bronchi was negatively correlated with FEV1% (P<0.05). Conclusion HRCT emphysema quantitative indexes and airway quantitative indexes have certain correlation with pulmonary function. It varies with different COPD grades, which can provide reference value for COPD evaluation.

关键词: 肺疾病，慢性阻塞性, 肺气肿, 体层摄影术，X线计算机, 肺功能, 肺密度

Key words: pulmonary disease, chronic obstructive, pulmonary emphysema, tomography, X-ray computed, pulmonary function, lung density

中图分类号:

R445.3

图/表 5

参考文献 26

[1]	BURNEY P G, PATEL J, NEWSON R, et al. Global and regional trends in COPD mortality,1990-2010[J]. Eur Respir J, 2015, 45(5):1239-1247. doi:10.1183/09031936.00142414.
[2]	WANG C, XU J, YANG L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health[CPH]study):A national cross-sectional study[J]. Lancet, 2018, 391(10131):1706-1717. doi:10.1016/S0140-6736(18)30841-9.
[3]	王雯婷, 王晓华, 贺蓓, 等. 基于吸呼双相CT定量参数的慢性阻塞性肺疾病影像学表型研究[J]. 中华医学杂志, 2021, 101(28):2242-2245.
	WANG W T, WANG X X, HE B, et al. Imaging phenotypes of chronic obstructive pulmonary disease based on biphasic quantitative CT features[J]. Natl Med J China, 2021, 101(28):2242-2245. doi:10.3760/cma.j.cn112137-20201223-03443.
[4]	OSTRIDGE K, WILLIAMS N P, KIM V, et al. Relationship of CT-quantified emphysema,small airways disease and bronchial wall dimensions with physiological,inflammatory and infective measures in COPD[J]. Respir Res, 2018, 19(1):31. doi:10.1186/s12931-018-0734-y.
[5]	郭佑民, 金晨望, 曹宪宪. 定量CT在慢性阻塞性肺疾病诊疗中的应用[J]. 中国医学影像技术, 2020, 36(3):332-334.
	GUO Y M, JIN C W, CAO X X. Application of quantitative CT in diagnosis and treatment of chronic obstructive pulmonary disease[J]. Chinese Journal of Medical Imaging Technology, 2020, 36(3):332-334. doi:10.13929/j.issn.1003-3289.2020.03.002.
[6]	HOGG J C, PARÉ P D, HACKETT T L. The contribution of small airway obstruction to the pathogenesis of chronic obstructive pulmonary disease[J]. Physiol Rev, 2017, 97(2):529-552. doi:10.1152/physrev.00025.2015.
[7]	曹宪宪, 金晨望, 郭佑民. CT定量评估肺气肿的研究现状[J]. 临床放射学杂志, 2019, 38(9):1787-1790.
	CAO X X, JIN C W, GUO Y M. Research status of CT quantitative evaluation of emphysema[J]. Journal of Clinical Radiology, 2019, 38(9):1787-1790. doi:10.13437/j.cnki.jcr.2019.09.047.
[8]	KONIETZKE P, WIELPÜTZ M O, WAGNER W L, et al. Quantitative CT detects progression in COPD patients with severe emphysema in a 3-month interval[J]. Eur Radiol, 2020, 30(5):2502-2512. doi:10.1007/s00330-019-06577-y.
[9]	王强, 罗勇, 李君. 慢性阻塞性肺疾病患者胸部高分辨率计算机断层成像肺气肿定量指标、气道管壁定量指标与肺功能的相关性研究[J]. 上海医学, 2020, 43(12):734-739.
	WANG Q, LUO Y, LI J. Correlation between chest high-resolution computed tomography quantitative indicators of emphysema, measurements of airway wall and pulmonary function test results in patients with chronic obstructive pulmonary disease[J]. Shanghai Med J, 2020, 43(12):734-739. doi:10.19842/j.cnki.issn.0253-9934.2020.12.006.
[10]	PARK J, HOBBS B D, CRAPO J D, et al. Subtyping COPD by using visual and quantitative CT imaging features[J]. Chest, 2020, 157(1):47-60. doi:10.1016/j.chest.2019.06.015.
[11]	马姣, 石芳, 崔涛, 等. 慢性阻塞性肺疾病患者高分辨率CT下表型的临床特征分析[J]. 国际呼吸杂志, 2019, 39(2):86-90.
	MA J, SHI F, CUI T, et al. Clinical characteristics and prognosis of chronic obstructive pulmonary disease phenotype classified by high resolution computer tomography[J]. International Journal of Respiration, 2019, 39(2):86-90. doi:10.3760/cma.j.issn.1673-436X.2019.02.002.
[12]	ZHANG L, JIANG B, WISSELINK H J, et al. COPD identification and grading based on deep learning of lung parenchyma and bronchial wall in chest CT images[J]. Br J Radiol, 2022, 95(1133):20210637. doi:10.1259/bjr.20210637.
[13]	LYNCH D A, AUSTIN J H, HOGG J C, et al. CT-definable subtypes of chronic obstructive pulmonary disease:A statement of the fleischner society[J]. Radiology, 2015, 277(1):192-205. doi:10.1148/radiol.2015141579.
[14]	LYNCH D A, MOORE C M, WILSON C, et al. CT-based visual classification of emphysema:Association with mortality in the COPDGene study[J]. Radiology, 2018, 288(3):859-866. doi:10.1148/radiol.2018172294.
[15]	SCHROEDER J D, MCKENZIE A S, ZACH J A, et al. Relationships between airflow obstruction and quantitative CT measurements of emphysema,air trapping,and airways in subjects with and without chronic obstructive pulmonary disease[J]. AJR Am J Roentgenol, 2013, 201(3):W460-W470. doi:10.2214/AJR.12.10102.
[16]	HAN M K, BARTHOLMAI B, LIU L X, et al. Clinical significance of radiologic characterizations in COPD[J]. COPD, 2009, 6(6):459-467. doi:10.3109/15412550903341513.
[17]	师美娟, 沈聪, 于楠, 等. 基于CT定量探讨不同级别慢性阻塞性肺疾病患者肺气肿肺叶分布[J]. 西安交通大学学报(医学版), 2019, 40(2):182-186.
	SHI M J, SHEN C, YU N, et al. Emphysema lobar distribution in patients with different degrees of chronic obstructive pulmonary disease based on quantitative CT analysis[J]. Journal of Xi'an Jiaotong University(Medical Sciences), 2019, 40(2):182-186. doi:10.7652/jdyxb201902003.
[18]	WRIGHT J L, LEVY R D, CHURG A. Pulmonary hypertension in chronic obstructive pulmonary disease:Current theories of pathogenesis and their implications for treatment[J]. Thorax, 2005, 60(7):605-609. doi:10.1136/thx.2005.042994.
[19]	黄晓旗, 牛媛, 雷禹, 等. 基于CT双气相定量研究吸烟合并慢性阻塞性肺疾病患者的肺叶小气道病变及肺气肿损伤程度[J]. 中华放射学杂志, 2022, 56(5):536-541.
	HUANG X Q, NIU Y, LEI Y, et al. Quantitative study on the degree of small airway disease and emphysema injury in pulmonary lobes of patients with smoking combined with chronic obstructive pulmonary disease based on biphasic CT[J]. Chin J Radiol, 2022, 56(5):536-541. doi:10.3760/cma.j.cn112149-20210428-00418.
[20]	XU F, VASILESCU D M, KINOSE D, et al. The molecular and cellular mechanisms associated with the destruction of terminal bronchioles in COPD[J]. Eur Respir J, 2022, 59(5):2101411. doi:10.1183/13993003.01411-2021.
[21]	TAKAYANAGI S, KAWATA N, TADA Y, et al. Longitudinal changes in structural abnormalities using MDCT in COPD:Do the CT measurements of airway wall thickness and small pulmonary vessels change in parallel with emphysematous progression?[J]. Int J Chron Obstruct Pulmon Dis, 2017, 12:551-560. doi:10.2147/COPD.S121405.
[22]	VASILESCU D M, MARTINEZ F J, MARCHETTI N, et al. Noninvasive imaging biomarker identifies small airway damage in severe chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2019, 200(5):575-581. doi:10.1164/rccm.201811-2083OC.
[23]	POMPE E, MOORE C M, MOHAMED HOESEIN F, et al. Progression of emphysema and small airways disease in cigarette smokers[J]. Chronic Obstr Pulm Dis, 2021, 8(2):198-212. doi:10.15326/jcopdf.2020.0140.
[24]	HOGG J C, CHU F, UTOKAPARCH S, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease[J]. N Engl J Med, 2004, 350(26):2645-2653. doi:10.1056/NEJMoa032158.
[25]	QIN S, YU X, MA Q, et al. Quantitative CT analysis of small airway remodeling in patients with chronic obstructive pulmonary disease by a new image post-processing system[J]. Int J Chron Obstruct Pulmon Dis, 2021, 16:535-544. doi:10.2147/COPD.S295320.
[26]	ZHAO D, ZHOU Y, JIANG C, et al. Small airway disease:A different phenotype of early stage COPD associated with biomass smoke exposure[J]. Respirology, 2018, 23(2):198-205. doi:10.1111/resp.13176.

组别	n		EI（%）
组别	n		左肺上叶		左肺下叶		右肺上叶		右肺中叶		右肺下叶
正常组	33		19.80（15.35，26.40）		15.40（10.15，22.55）		16.60（12.80，25.45）		23.80（14.70，28.70）		14.90（13.45，23.95）
COPD组	109		32.70（25.15，37.60）^a		29.40（20.55，36.55）^a		30.40（23.55，36.70）^a		31.30（24.90，39.35）^a		27.20（19.30，36.00）^a
GOLDⅠ级组	29		26.60（25.05，33.30）^a		20.60（16.55，29.40）		27.00（25.00，31.10）^a		27.00（22.60，33.40）		23.50（15.75，27.70）
GOLDⅡ级组	38		31.40（22.85，37.55）^a		28.45（20.10，35.53）^a		29.70（21.48，34.58）^a		30.90（25.90，38.23）^a		26.20（21.88，35.95）^a
GOLDⅢ+Ⅳ级组	42		35.80（26.4，41.83）^a		34.60（21.87，45.70）^abc		33.05（23.50，41.57）^a		37.75（26.60，44.08）^ab		35.55（25.58，42.98）^abc
χ²			5.128^＊＊		5.403^＊＊		5.142^＊＊		4.429^＊＊		5.144^＊＊
组别		MLD（HU）
组别		左肺上叶		左肺下叶		右肺上叶		右肺中叶		右肺下叶
正常组		-860（-873，-846）		-840（-856，-814）		-855（-869，-840）		-867（-867，-844）		-840（-856，-815）
COPD组		-875（-890，-860）^a		-865（-884，-842）^a		-870（-885，-855）^a		-878（-889，-861）^a		-860（-880，-835）^a
GOLDⅠ级组		-866（-885，-854）		-846（-871，-802）		-861（-879，-838）		-872（-884，-847）		-846（-865，-798）
GOLDⅡ级组		-873（-888，-862）^a		-861（-881，-840）^a		-870（-883，-856）^a		-875（-889，-859）		-852（-882，-820）
GOLDⅢ+Ⅳ级组		-884（-896，-867）^ab		-879（-898，-859）^ab		-874（-897，-861）^ab		-885（-896，-867）^ab		-877（-897，-859）^abc
χ²		3.585^＊＊		4.290^＊＊		3.495^＊＊		3.039^＊＊		3.340^＊＊

组别	n		EI（%）
组别	n		左肺上叶		左肺下叶		右肺上叶		右肺中叶		右肺下叶
正常组	33		19.80（15.35，26.40）		15.40（10.15，22.55）		16.60（12.80，25.45）		23.80（14.70，28.70）		14.90（13.45，23.95）
COPD组	109		32.70（25.15，37.60）^a		29.40（20.55，36.55）^a		30.40（23.55，36.70）^a		31.30（24.90，39.35）^a		27.20（19.30，36.00）^a
GOLDⅠ级组	29		26.60（25.05，33.30）^a		20.60（16.55，29.40）		27.00（25.00，31.10）^a		27.00（22.60，33.40）		23.50（15.75，27.70）
GOLDⅡ级组	38		31.40（22.85，37.55）^a		28.45（20.10，35.53）^a		29.70（21.48，34.58）^a		30.90（25.90，38.23）^a		26.20（21.88，35.95）^a
GOLDⅢ+Ⅳ级组	42		35.80（26.4，41.83）^a		34.60（21.87，45.70）^abc		33.05（23.50，41.57）^a		37.75（26.60，44.08）^ab		35.55（25.58，42.98）^abc
χ²			5.128^＊＊		5.403^＊＊		5.142^＊＊		4.429^＊＊		5.144^＊＊
组别		MLD（HU）
组别		左肺上叶		左肺下叶		右肺上叶		右肺中叶		右肺下叶
正常组		-860（-873，-846）		-840（-856，-814）		-855（-869，-840）		-867（-867，-844）		-840（-856，-815）
COPD组		-875（-890，-860）^a		-865（-884，-842）^a		-870（-885，-855）^a		-878（-889，-861）^a		-860（-880，-835）^a
GOLDⅠ级组		-866（-885，-854）		-846（-871，-802）		-861（-879，-838）		-872（-884，-847）		-846（-865，-798）
GOLDⅡ级组		-873（-888，-862）^a		-861（-881，-840）^a		-870（-883，-856）^a		-875（-889，-859）		-852（-882，-820）
GOLDⅢ+Ⅳ级组		-884（-896，-867）^ab		-879（-898，-859）^ab		-874（-897，-861）^ab		-885（-896，-867）^ab		-877（-897，-859）^abc
χ²		3.585^＊＊		4.290^＊＊		3.495^＊＊		3.039^＊＊		3.340^＊＊

组别		n	WA（mm²）			LA（mm²）			WA%
组别		n	4级	5级	6级	4级	5级	6级	4级	5级	6级
正常组	33		26.04±4.36	19.17±3.07	15.50±3.38	12.03±4.03	7.53±2.35	4.26±1.61	68.79±4.91	72.35±4.96	78.58±5.86
COPD组	109		26.84±4.60	20.26±3.09^a	16.47±3.45^a	11.43±2.74	6.50±1.61^a	3.57±1.07^a	70.27±4.15^a	75.87±3.65^a	82.45±3.67^a
GOLDⅠ级组	29		26.96±3.91	20.10±2.73^a	16.03±2.39	11.48±2.18	6.52±1.62^a	3.81±1.25^a	70.19±3.65^a	75.73±4.11^a	81.31±3.86^a
GOLDⅡ级组	38		27.15±5.23^a	20.37±3.28^a	16.76±4.52^ab	11.36±3.28	6.46±1.62^a	3.47±1.12^ab	70.44±5.30^a	76.49±3.40^a	83.10±3.98^ab
GOLDⅢ＋Ⅳ级组	42		26.43±4.31	20.27±2.98^a	16.47±2.96^a	11.45±2.58	6.52±1.61^a	3.50±0.86^ab	70.16±3.18^a	75.51±3.38^ac	82.63±3.03^ab
F			2.665^＊	5.084^＊＊	4.368^＊＊	2.468	16.528^＊＊	17.059^＊＊	5.762^＊＊	41.266^＊＊	48.088^＊＊

组别		n	WA（mm²）			LA（mm²）			WA%
组别		n	4级	5级	6级	4级	5级	6级	4级	5级	6级
正常组	33		26.04±4.36	19.17±3.07	15.50±3.38	12.03±4.03	7.53±2.35	4.26±1.61	68.79±4.91	72.35±4.96	78.58±5.86
COPD组	109		26.84±4.60	20.26±3.09^a	16.47±3.45^a	11.43±2.74	6.50±1.61^a	3.57±1.07^a	70.27±4.15^a	75.87±3.65^a	82.45±3.67^a
GOLDⅠ级组	29		26.96±3.91	20.10±2.73^a	16.03±2.39	11.48±2.18	6.52±1.62^a	3.81±1.25^a	70.19±3.65^a	75.73±4.11^a	81.31±3.86^a
GOLDⅡ级组	38		27.15±5.23^a	20.37±3.28^a	16.76±4.52^ab	11.36±3.28	6.46±1.62^a	3.47±1.12^ab	70.44±5.30^a	76.49±3.40^a	83.10±3.98^ab
GOLDⅢ＋Ⅳ级组	42		26.43±4.31	20.27±2.98^a	16.47±2.96^a	11.45±2.58	6.52±1.61^a	3.50±0.86^ab	70.16±3.18^a	75.51±3.38^ac	82.63±3.03^ab
F			2.665^＊	5.084^＊＊	4.368^＊＊	2.468	16.528^＊＊	17.059^＊＊	5.762^＊＊	41.266^＊＊	48.088^＊＊

部位	EI		MLD
部位	r_s	P	r_s	P
左肺上叶	-0.500	<0.001	0.431	<0.001
左肺下叶	-0.629	<0.001	0.524	<0.001
右肺上叶	-0.482	<0.001	0.431	<0.001
右肺中叶	-0.465	<0.001	0.366	<0.001
右肺下叶	-0.586	<0.001	0.491	<0.001

慢性阻塞性肺疾病患者HRCT定量指标与肺功能的相关性研究

The correlation research of quantitative index of HRCT and lung function in patients with chronic obstructive pulmonary disease

引用本文

RichHTML

PDF (PC)

可视化

摘要/Abstract

使用本文

图/表 5

参考文献 26

相关文章 15

编辑推荐

Metrics

本文评价

支气管	WA		LA		WA%
支气管	r_s	P	r_s	P	r_s	P
4级	-0.039	0.711	0.112	0.092	-0.168	0.082
5级	-0.073	0.482	0.194	0.062	-0.201	0.036
6级	-0.125	0.229	0.175	0.092	-0.195	0.043

[1]	张兰英, 张福安, 刘茂茂, 陈杰, 周健, 刘钰婷, 欧阳瑶. CD1a⁺和CD83⁺树突状细胞在COPD小鼠肺组织中的分布及意义[J]. 天津医药, 2024, 52(9): 913-916.
[2]	李冬生, 秦艺榕, 乔曼, 迟航, 崔青敏, 李晓秋. 清咳平喘颗粒对COPD急性加重期的临床疗效[J]. 天津医药, 2024, 52(8): 854-857.
[3]	赵术彤, 丁运, 李月川, 赵晓赟, 耿华, 徐美林. 轻度慢性阻塞性肺疾病的病理特征及其与炎性因子的相关性[J]. 天津医药, 2024, 52(6): 643-647.
[4]	冯李婷, 李莉, 谢鑫, 王星. 天津地区部分居民慢性阻塞性肺疾病影响因素分析[J]. 天津医药, 2024, 52(4): 427-431.
[5]	刘燕, 许靖, 马蕾, 曹冠亚, 赵凤德. AECOPD患者外周血EOS、D-D和NLR与肺通气功能的关系[J]. 天津医药, 2024, 52(12): 1261-1265.
[6]	屠昌明, 田园, 汪鹏程, 任鹏, 赵寅生. SII、RAR与AECOPD患者病情严重程度及并发呼吸衰竭的关系[J]. 天津医药, 2024, 52(12): 1317-1321.
[7]	于志鸿, 王小琴. 欧前胡素衍生物对COPD肺泡Ⅱ型细胞活性及耐药蛋白的影响[J]. 天津医药, 2024, 52(11): 1127-1130.
[8]	苏振磊, 杨万春, 韩天龙. 血清CXCL9和SFRP1在AECOPD合并肺栓塞患者中的表达及对预后的影响[J]. 天津医药, 2023, 51(4): 427-431.
[9]	聂进, 刘代顺, 张建勇, 刘楚, 周亮. 脐带间充质干细胞外泌体对慢性阻塞性肺疾病大鼠肺部炎症的作用机制探讨[J]. 天津医药, 2023, 51(12): 1326-1331.
[10]	朱鹏飞, 聂晓红, 周倩, 张美凤, 姚梦蝶, 周晴, 肖祝. 肠内营养粉对老年稳定期COPD患者肺功能及BODE指数的影响[J]. 天津医药, 2023, 51(11): 1232-1236.
[11]	陈健, 杨莉, 金杰, 王磊, 董敏, 柴国祥. 胸腔引流微管与胸腔镜治疗肺气肿合并巨大肺大疱的临床疗效比较[J]. 天津医药, 2022, 50(7): 761-765.
[12]	王亚锋, 夏晓黎△, 马艳萍, 张宁, 魏才杰, 马娇娇. 体外膈肌起搏器联合呼吸训练器对稳定期COPD合并Ⅱ型呼吸衰竭患者的临床疗效观察#br#[J]. 天津医药, 2022, 50(5): 498-502.
[13]	孙琦, 文洽先, 王庆华, 堵红群 . PET/CT定量参数联合血液学指标对免疫检查点抑制剂联合化疗治疗晚期肺癌患者预后的预测价值[J]. 天津医药, 2022, 50(4): 399-403.
[14]	何媛, 李冬生, 李月红. 丹红注射液治疗CKD伴低氧血症COPD患者的临床疗效观察[J]. 天津医药, 2021, 49(7): 747-751.
[15]	何永鸿, 强丽, 王宋平. 阿托伐他汀钙对COPD模型大鼠肺血管重塑的影响及机制探讨[J]. 天津医药, 2021, 49(6): 598-602.