Hachem Ramsey R, Chakinala Murali M, Yusen Roger D, Lynch John P, Aloush Aviva A, Patterson G Alexander, Trulock Elbert P
Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
Am J Respir Crit Care Med. 2004 Feb 15;169(4):468-72. doi: 10.1164/rccm.200307-1018OC. Epub 2003 Dec 11.
Bronchiolitis obliterans syndrome (BOS) remains the main cause of graft loss after lung transplantation. Stage 0-p was recently added to the staging criteria to detect early deterioration in allograft function that might presage BOS stage 1. We assessed the predictive value of stage 0-p by retrospectively analyzing spirometric data for 203 adult bilateral lung transplant recipients. The FEV(1) criterion for stage 0-p had a positive predictive value of 79% and a negative predictive value of 82%. In contrast, the FEF(25-75%) criterion for stage 0-p had a positive predictive value of 52% and a negative predictive value of 72%. Fifty-seven percent of subjects who developed stage 0-p by the FEV(1) criterion progressed to stage 1 within 1 year, whereas only 37% of those who developed stage 0-p by the FEF(25-75%) criterion progressed to stage 1 within 1 year. We conclude that the FEV(1) criterion for stage 0-p is a reasonable predictor of BOS stage 1 after bilateral lung transplantation, but the FEF(25-75%) criterion for stage 0-p is not predictive of BOS stage 1 after bilateral lung transplantation.
闭塞性细支气管炎综合征（BOS）仍然是肺移植后移植物丢失的主要原因。0-p期最近被纳入分期标准，以检测可能预示BOS 1期的同种异体移植物功能早期恶化情况。我们通过回顾性分析203例成年双侧肺移植受者的肺功能数据，评估了0-p期的预测价值。0-p期的FEV(1)标准的阳性预测值为79%，阴性预测值为82%。相比之下，0-p期的FEF(25-75%)标准的阳性预测值为52%，阴性预测值为72%。根据FEV(1)标准发展为0-p期的受试者中，57%在1年内进展为1期，而根据FEF(25-75%)标准发展为0-p期的受试者中，只有37%在1年内进展为1期。我们得出结论，0-p期的FEV(1)标准是双侧肺移植后BOS 1期的合理预测指标，但0-p期的FEF(25-75%)标准不能预测双侧肺移植后BOS 1期。
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