Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan.
Allergy Asthma Immunol Res. 2013 Sep;5(5):322-8. doi: 10.4168/aair.2013.5.5.322. Epub 2013 Jul 24.
Recently, the clinical application of the forced oscillation technique (FOT) has progressed with the spread of commercially available FOT devices, including the impulse oscillation system and MostGraph. We investigated the usefulness of color 3D imaging of respiratory impedance in asthma using MostGraph.
Whole-breath and within-breath respiratory system resistance (Rrs) and reactance (Xrs) were measured in 78 patients with asthma. Color 3D images were classified into three patterns: the chronic obstructive pulmonary disease (COPD)-like pattern (high values of Rrs and Xrs with a marked respiratory cycle and frequency dependence), the asthma pattern (moderately high Rrs over the entire frequency and a respiratory cycle with slight Xrs changes), and a normal-like pattern (low Rrs and Xrs with few within-breath changes). The classification was performed by three researchers, who were unaware of the clinical information, and the clinical characteristics were compared among the three groups.
Color 3D imaging provided a COPD-like pattern in 25 patients, an asthma pattern in 39 patients, and a normal-like pattern in 14 patients. Patients with the COPD-like pattern were predominantly female with a higher body mass index, lower forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and higher Rrs and Xrs values (whole-breath and within-breath variation). Those with the normal pattern had higher FEV1 and FVC, and a lower single-breath nitrogen washout slope. There were no differences in asthma control or exhaled nitric oxide levels among the three groups.
These results suggest that color 3D imaging of respiratory impedance may show asthma phenotypes.
随着商业可用的强迫震荡技术(FOT)设备(包括脉冲震荡系统和 MostGraph)的普及,FOT 的临床应用最近取得了进展。我们使用 MostGraph 研究了呼吸阻抗彩色 3D 成像在哮喘中的应用价值。
我们测量了 78 例哮喘患者的全呼吸和呼吸内呼吸阻抗的系统阻力(Rrs)和电抗(Xrs)。将彩色 3D 图像分为三种模式:慢性阻塞性肺疾病(COPD)样模式(Rrs 和 Xrs 值高,呼吸周期和频率依赖性明显)、哮喘样模式(整个频率的 Rrs 值较高,呼吸周期的 Xrs 变化轻微)和正常样模式(Rrs 和 Xrs 值低,呼吸内变化少)。由三名研究人员进行分类,他们不知道临床信息,并比较了三组的临床特征。
彩色 3D 成像在 25 例患者中提供了 COPD 样模式,在 39 例患者中提供了哮喘样模式,在 14 例患者中提供了正常样模式。COPD 样模式的患者主要为女性,体重指数较高,用力呼气量(FEV1)和用力肺活量(FVC)较低,Rrs 和 Xrs 值(全呼吸和呼吸内变化)较高。正常模式的患者 FEV1 和 FVC 较高,单次呼气氮清除斜率较低。三组之间的哮喘控制或呼出一氧化氮水平没有差异。
这些结果表明,呼吸阻抗的彩色 3D 成像可能显示哮喘表型。