【摘要】 目的:探究多层螺旋CT(MSCT)定量参数联合血清组织型金属蛋白酶抑制物-1(TIMP-1)、低氧诱导因子-1α(HIF-1α)在慢性阻塞性肺疾病(COPD)诊治中的应用价值。方法:选取2021年9月至2023年9月，于我院进行诊断的疑似COPD患者83例，经病理学检查，以及肺功能、胸部CT确诊52例患者为COPD,为观察组，其余患者31例为对照组。均进行MSCT定量检查。计算MSCT定量参数壁厚度与直径比值(TDR)、管腔面积(Ai)、管壁厚度与体表面积比值(T/BSA)、支气管壁面积百分比(WA%)情况；酶联免疫吸附试验法检测TIMP-1、HIF-1α水平情况；多因素Logistic回归分析影响COPD发生的独立风险因素；分析MSCT定量参数与TIMP-1、HIF-1α的相关性；分析TIMP-1、HIF-1α与疾病不同病情严重程度之间的相关性。结果:与对照组相比，观察组TIMP-1、HIF-1α、TDR、T/BSA、WA%参数水平升高，Ai水平降低(P<0.05);重度者TDR、T/BSA、WA%参数水平高于轻度和中度患者，Ai水平低于轻度和中度患者(P<0.05);与轻度和中度患者相比，重度患者TIMP-1、HIF-1α水平均升高(P<0.05);多因素Logistic回归分析结果显示，影响COPD发生的独立风险因素包括TDR、HIF-1α、T/BSA、Ai、TIMP-1、WA%。TDR、T/BSA、WA%与疾病严重程度呈正相关；Ai水平与疾病严重程度呈负相关，TIMP-1、HIF-1α水平与疾病严重程度呈正相关(P<0.05);TDR、T/BSA、WA%与TIMP-1、HIF-1α均呈正相关(P<0.05);Ai与TIMP-1、HIF-1α水平均呈负相关(P<0.05)。联合诊断的效能均显著高于TIMP-1、HIF-1α单独诊断的效能。结论:MSCT定量参数与TIMP-1、HIF-1α水平及疾病不同病情严重程度之间具有相关性，提高临床在COPD中的应用价值。更多还原

【Abstract】 Objective: To investigate the value of quantitative multislice spiral CT(MSCT) parameters combined with serum tissue-type inhibitor of metalloproteinase-1(TIMP-1) and hypoxia-inducible factor-1α(HIF-1α) in the diagnosis and management of chronic obstructive pulmonary disease(COPD).Methods: A total of 83 suspected COPD patients diagnosed in our hospital from September 2021 to September 2023 were selected. After pathological examination, as well as lung function and chest CT, 52 patients were confirmed to have COPD and were classified as the observation group, while the remaining 31 patients were classified as the control group. All underwent MSCT quantitative examination. The quantitative parameters of MSCT were calculated, including the ratio of wall thickness to diameter(TDR), lumen area(Ai), the ratio of wall thickness to body surface area(T/BSA), and the percentage of bronchial wall area(WA%). The levels of TIMP-1 and HIF-1α were detected. Multivariate Logistic regression analysis was conducted to analyze the independent risk factors influencing the occurrence of COPD. The correlation between the quantitative parameters of MSCT and TIMP-1 and HIF-1α was analyzed. The correlation between TIMP-1, HIF-1α and different severity levels of the disease were analyzed. Results:Compared with the control group, the parameter levels of TIMP-1, HIF-1α, TDR, T/BSA and WA% in the observation group increased, while the Ai level decreased(P<0.05). The parameter levels of TDR, T/BSA and WA% in severe patients were higher than those in mild and moderate patients, while the Ai level was lower than that in mild and moderate patients(P<0.05). Compared with mild and moderate patients, the levels of TIMP-1 and HIF-1α in severe patients were both increased(P<0.05). The results of multivariate Logistic regression analysis showed that the independent risk factors influencing the occurrence of COPD included TDR, HIF-1α, T/BSA, Ai, TIMP-1, and WA%. TDR, T/BSA and WA% are positively correlated with the severity of the disease. The level of Ai was negatively correlated with the severity of the disease, while the levels of TIMP-1 and HIF-1α were positively correlated with the severity of the disease(P<0.05). TDR, T/BSA, WA% were positively correlated with TIMP-1 and HIF-1α(P<0.05). Ai was negatively correlated with the levels of TIMP-1 and HIF-1α(P<0.05). The efficacy of the combined diagnosis was significantly higher than that of the individual diagnoses of TIMP-1 and HIF-1α. Conclusion:The correlation between the quantitative parameters of multilayer spiral CT and TIMP-1, HIF-1 α levels and different disease severity, which improves the clinical application in chronic obstructive pulmonary disease.更多还原