目的:探讨COPD患者胸部CT检查胸大肌面积与全身骨骼肌质量相关性,进一步探讨胸大肌横断面积能够预测COPD病程严重性.方法:收集2014年1月-2015年12月期间的435例COPD患者,均执行低剂量胸部CT和生物a阻抗分析,并记录所有放射数据和病史记载.在主动脉弓横断层面定量分析胸大肌面积,后进行测量.感性兴趣区(ROI)勾画出胸大肌.应用BIA系统分析身体成分.应用X-扫描II 8-触极电极系统测量总体或部分阻抗(手臂、大腿及躯干)和不同频率(1,5,50,250,550,1000 kHz)交变电流强化相角.结果:COPD实验者较对照组胸大肌面积明显减低,其差异具有统计学意义(P<0.001).总体胸大肌平均横断面积为(24.1±6.8)cm2,范围:(8.1-52.3)cm2.女性患者和老年患者胸大肌面积较小(15.3±3.1)cm2比(26.4±5.4)cm2,P<0.001.BIA评估全身骨骼肌质量的平均值为(31.4±6.5)kg,范围:(16.7–45.0)kg,SMM与年龄、身高、体重、胸大肌面积的相关系数范围为-0.289-0.831,胸大肌面积与SMM r为0.665.校正年龄、性别、身高和体重后,CT扫描横断面胸大肌面积与BIA测量胸大肌质量的仍具有关系(校正相关系数为0.290).通过多变量分析,每增加1cm2等于胸大肌质量增大0.135 kg(95%CI为0.093-0.178,P<0.001).结论:低剂量胸部CT检查,在主动脉层面测量胸大肌横断面面积能够评估全身骨骼肌质量,且能预测COPD的严重性.%Objective: To investigate the correlation between chest and COPD total body skeletal muscle mass in chest CT, and to explore the prediction of the severity of COPD. Methods: 435 COPD patients with 2014.1-2015.12 were collected and analyzed with low dose chest CT and bio impedance, and all the data and medical history were recorded. Quantitative analysis of large muscle area at the aortic arch transection level. Area of interest (ROI) outlines the major muscle of the chest. Application of BIA system (South Korea Ⅱ X-SCANPLUS) analysis of body composition. Application of X- scanning II 8- contact electrode system for measuring the total or partial impedance (arm, thigh and torso) and different frequencies (1, 5, 50, 250, 550, 1000 KHz) enhanced phase alternating current. Results: compared with the control group, the COPD of the thoracic major muscle area was significantly reduced, and the difference was statistically significant (P<0.001). The overall average cross-sectional area of the major chest muscle was (24.1±26.8) cm2(range: 8.1-52.3cm2). Female patients and elderly patients with a small area of the chest muscle (15.3±3.1) cm2 (26.4± 5.4)cm2 ,P<0.001. The average value of BIA evaluation of skeletal muscle mass is (31.4±6.5) kg (range: 16.7-45.0 kg), the correlation coefficient range of SMM with age, height, weight, chest muscle area is -0.289-0.831, pectoralis major area and SMM for R is 0.665. After adjusting for age, sex, height, and weight, the CT scan had a relationship with the mass of the chest muscle mass of the BIA scan, and the correlation coefficient was 0.290. By multivariate analysis, each increase of 1cm2 equal to the pectoralis major muscle mass increases 0.135 kg (95% CI, 0.093-0.178,P<0.001). Conclusion: Low dose chest CT examination, to assess the general quality of the skeletal muscle in the aorta level measurement of pectoralis major muscle cross-sectional area, severity and predict COPD.
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