COPD：emphysema-dominant vs airway disease dominant

COPDに関して、emphysema-dominantか、airway disease dominant か
441名のCOPD GOLD stage 1-3に関して、臨床評価、生理学的評価、検査室検査、標準定量化CT(QCT)：気腫・気道壁geometry評価


pink pufferと、blue bloaterと呼ばれていた臨床特性がよみがえる


Emphysema- and airway-dominant COPD phenotypes defined by standardised quantitative computed tomography
Deepak R. et. al.
European Respiratory Journal, Vol.47 (6)
DOI: 10.1183/13993003.01878-2015 Published 26 May 2016

QCT指標は、scanner non-conformityに影響されるが、標準化によりばらつき減少 

4つのphenotypeへ分類：g “emphysema-dominant”、“airway disease-dominant”、“mixed” disease 、 “mild” disease


emphysema-dominant群は、airway-dominant群比較して、lung volume高値、ガス交換指標低下、PaO2、PCO2低下、ヘモグロビン高値、白血球数増加

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15th percentile (Perc15) point derived from the lung density histogram was used to assess emphysema severity
% wall area (%WA) for the right S1 segmental bronchus was used to assess airway disease.