不同运动状态下慢性阻塞性肺疾病患者下呼吸道内的气流特性
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牡丹江医学院·周志尊博士科研启动基金资助


Airflow Characteristics of Lower Respiratory Tract in Patients with Chronic Obstructive Pulmonary Disease under Different Motion States
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    摘要:

    目的 运用计算流体动力学方法探究不同运动状态下慢性阻塞性肺疾病( chronic obstructive pulmonary disease, COPD)患者下呼吸道内气流特性。 方法 收集稳定期 COPD 患者肺部 CT 扫描数据与肺功能数据,重建下呼吸道三维模型,通过施加个体化边界条件进行数值模拟,分析患者下呼吸道壁面压力、壁面剪切应力(wall shear stress, WSS)、气流速度以及压降等参数。 结果 随着运动强度增加,COPD 患者下呼吸道壁面压力、WSS、流速及压降呈逐渐上升趋势。 静息状态与低强度运动状态各参数相差较小,高强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,3 种运动状态下 WSS>1. 0 Pa 所占面积分别为 272. 35、438. 24、4 369. 48 mm2。 结论运动状态下,COPD 患者气道壁面压力、WSS、流速以及压降显著增加,增大患者气道黏膜损伤以及炎症的可能性。 研究结果从力学角度解释 COPD 患者发生支气管炎症机制以及患者无法长时间运动的原因。

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    Objective To investigate characteristics of the airflow in lower respiratory tract for patient with chronic obstructive pulmonary disease (COPD) under different motion states using computational fluid dynamics (CFD) method. Methods The CT scanning data and pulmonary function data of COPD patients were collected to reconstruct the three-dimensional (3D) model of lower respiratory tract. The numerical simulation was performed by applying individualized boundary conditions, so as to analyze parameters such as wall pressure, wall shear stress ( WSS), flow rate and pressure drop in lower respiratory tract of the patient. Results With exercise intensity increasing, the wall pressure, WSS, flow velocity and pressure drop of lower respiratory tract in COPD patients gradually increased. The differences in parameters between the resting state and low-intensity exercisestate were small, while such parameters under high-intensity exercise state increased significantly. Among the parameters, WSS was a sensitive mechanical parameter, and the area occupied by WSS>1. 0 Pa was 272. 35, 438. 24, 4 369. 48 mm2 under three motion states, respectively. Conclusions The airway wall pressure, WSS, flow velocity and pressure drop of COPD patients under motion states are significantly increased, which increases the possibility of mucosal injury and inflammation in lower respiratory tract. The results explain the mechanism of bronchial inflammation in COPD patients and the reasons why patients cannot exercise for a long time from the mechanical perspective.

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成志国,陈晓琴,黄城督,钟 彦,明照凯,陈广新,周志尊.不同运动状态下慢性阻塞性肺疾病患者下呼吸道内的气流特性[J].医用生物力学,2023,38(4):677-682

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  • 收稿日期:2022-08-22
  • 最后修改日期:2022-09-02
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  • 在线发布日期: 2023-08-25
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