الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Small airway is inflamed in asthma and good data suggest that their remodeling is an important determinant of the altered airway physiology. The introduction of High Resolution Computed Tomography allows assessment of morphological changes (air trapping and regional hyperinflation) resulting from the small airways affection that are associated with dysfunction not identified with lung function testing. Aim: This work was planned to Quantify airway wall thickness Study small airways of asthmatic subjects, through its effect on lung function and HRCT changes. Methods: The present study comprised 50 persons, classified into: group (Qf? (Bincluded 15severe persistent asthmatic patients. group (Qff? (Bincluded 10 moderate persistent asthmatic patients. group (N{: (Bincluded 8 mild persistent asthmatic patients. group V(Qf? (Bincluded 7 intermittent asthmatic patients. group V (control): included 10 healthy volunteers. Lung function study and HRCT were done Result: Small airway function tests (Frequency dependence compliance and FEF50% %) were lower in asthmatic patients than control especially, in group I and II Airway wall thickening (WA% and T/D ratio) at various HRCT levels occurred in patients with asthma and not limited only to those with severe asthma. The increase in clinical indices of asthma (duration of asthma illness, numbers of acute attacks in the last year and asthma severity score) was associated with decrease in indices of airway obstruction (FEV1% of predicted, FEV1/FVC, FEF50% and PEF). Airway obstruction indices (FEV1% of predicted, FEV1/FVC, FEF50% and PEF) showed a negative significant correlation with airway thickening. Conclusion: Poor asthma control both clinically and physiologically could be explained by remodeling not only to small but also lung parenchyma as well. Although, airflow obstruction is correlated with the duration and severity, yet airway thickening is not limited to any group regarding severity. HRCT is a useful noninvasive tool in diagnosis of airway thickening and morphological changes resulting from small airway affection, which helps us toward better understanding of pathogenesis of asthma. |