不同运动状态下慢性阻塞性肺疾病患者下呼吸道内气流特性
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牡丹江医学院医学影像学院

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R 318

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Airflow characteristics in the lower airways of patients with chronic obstructive pulmonary disease under different exercise conditions
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    摘要:

    目的:运用计算流体力学方法探究不同运动状态下慢性阻塞性肺疾病患者下呼吸道内气流特性。方法:收集慢阻肺患者肺部CT扫描数据与肺功能数据,重建其真实下呼吸道三维模型,通过施加个体化边界条件进行数值模拟,并分析患者下呼吸道壁面压力、壁面剪切应力(Wall shear stress, WSS)、流速以及压降等参数。结果:随着运动强度增加,慢阻肺患者下呼吸道壁面压力、WSS、流速及压降呈逐渐上升趋势。静息状态与轻度运动状态各参数相差较小,重度运动状态各参数显著增加。其中WSS是一个较敏感的力学指标,三种呼吸状态下WSS大于1 Pa所占面积分别为272.35 mm2438.24 mm24369.48 mm2结论:运动状态下患者气道壁面压力、WSS、流速以及压降显著增大,增大患者气道粘膜损伤以及炎症的可能性。从力学角度解释COPD患者发生支气管炎症机理以及患者无法长时间运动的原因。

    Abstract:

    Objective: To investigate the characteristics of airflow in the lower airways of patient with chronic obstructive pulmonary disease under different exercise conditions using computational fluid dynamics methods. Methods: The CT scan data and pulmonary function data of patients with COPD were collected to reconstruct the real three-dimensional model of the lower respiratory tract. And the numerical simulation was performed by applying individualized boundary conditions, then we analyzed parameters such as wall pressure, wall shear stress (WSS), flow rate and pressure drop in the patients" lower airways. Results: With increasing exercise intensity, the wall pressure, WSS, flow velocity and pressure drop of lower respiratory tract in COPD patients gradually increased. The difference between the resting state and the mild exercise state was small, while the parameters of severe exercise state increased significantly. Among them, WSS was a sensitive mechanical index, and the area occupied by WSS greater than 1 Pa was 272.35 mm2, 438.24 mm2 and 4369.48 mm2 in the three breathing states, respectively. Conclusion: The airway wall pressure, WSS, flow velocity and pressure drop of patients in exercise state are significantly increased, which increases the possibility of airway mucosal injury and inflammation. Explain the mechanism of bronchial inflammation in COPD patients and the reasons why patients cannot exercise for a long time from a mechanical point of view.

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  • 收稿日期:2022-08-22
  • 最后修改日期:2022-09-21
  • 录用日期:2022-09-23
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