Moreau Ludovic, Crenesse Dominique, Berthier Frederic, Albertini Marc
Pulmonary Function Tests laboratory, Department of Pediatrics, Hospital Archet II, University of Nice Sofia Antipolis, Nice, France.
Acta Paediatr. 2009 Jun;98(6):1019-23. doi: 10.1111/j.1651-2227.2009.01246.x. Epub 2009 May 12.
The aim of our retrospective study was to determine the relationship between impulse oscillometry (IOS) data and spirometric tests in cystic fibrosis (CF) children. methods: Thirty CF children aged 4-19 years have performed lung function tests (LFT). A subset of 15 patients repeated LFT on five separate occasions. IOS parameters were respiratory resistance (Rrs), reactance (Xrs) and impedance at 5 Hz (R5, X5, Zr) and the resonant frequency (Fres). Spirometry indices (SI) included forced expiratory volume in 1 sec (FEV(1)), forced expiratory flow during the middle half of FVC (FEF(25-75)) and forced vital capacity (FVC).
An inverse relationship was observed between raw values of R5, Zr, Fres and SI respectively, and X5 correlated positively with SI. Although significant, these correlations were poor. Receiver operating characteristic curves (ROC) were constructed to identify cutoff points for IOS parameters to discriminate between children according to predefined FEV(1) thresholds (percent predicted), generally used to categorize the level of lung function impairment. No acceptable cutoff points can be found for IOS parameters. Trends analyses in the subgroup of 15 patients showed a significant decline of FEV(1) between the first and the fifth evaluation. None of the IOS indices demonstrated a consistent tendency, apart from a slight decrease of Fres.
IOS measurements presented an insufficient sensitivity to detect and follow bronchial obstruction in CF patients.
我们这项回顾性研究的目的是确定脉冲振荡法(IOS)数据与囊性纤维化(CF)患儿肺量计测试之间的关系。
30名年龄在4至19岁的CF患儿进行了肺功能测试(LFT)。15名患者的一个亚组在五个不同时间重复进行了LFT。IOS参数包括呼吸阻力(Rrs)、电抗(Xrs)以及5赫兹时的阻抗(R5、X5、Zr)和谐振频率(Fres)。肺量计指标(SI)包括1秒用力呼气量(FEV(1))、用力肺活量(FVC)中半程的用力呼气流量(FEF(25 - 75))和用力肺活量(FVC)。
分别观察到R5、Zr、Fres的原始值与SI之间呈负相关,而X5与SI呈正相关。尽管这些相关性显著,但都很弱。构建了受试者工作特征曲线(ROC)以确定IOS参数的截断点,以便根据预先定义的FEV(1)阈值(预测百分比)区分儿童,该阈值通常用于对肺功能损害程度进行分类。未找到IOS参数的可接受截断点。15名患者亚组的趋势分析显示,第一次和第五次评估之间FEV(1)显著下降。除了Fres略有下降外,没有一个IOS指标表现出一致的趋势。
IOS测量对检测和跟踪CF患者的支气管阻塞敏感性不足。