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囊性纤维化成人患者的强迫振荡与呼吸系统建模

Forced oscillations and respiratory system modeling in adults with cystic fibrosis.

作者信息

Lima Adma N, Faria Alvaro C D, Lopes Agnaldo J, Jansen José M, Melo Pedro L

机构信息

Pulmonary Function Laboratory - Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.

Biomedical Instrumentation Laboratory - Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Biomed Eng Online. 2015 Feb 13;14:11. doi: 10.1186/s12938-015-0007-7.

Abstract

BACKGROUND

The Forced Oscillation Technique (FOT) has the potential to increase our knowledge about the biomechanical changes that occur in Cystic Fibrosis (CF). Thus, the aims of this study were to investigate changes in the resistive and reactive properties of the respiratory systems of adults with CF.

METHODS

The study was conducted in a group of 27 adults with CF over 18 years old and a control group of 23 healthy individuals, both of which were assessed by the FOT, plethysmography and spirometry. An equivalent electrical circuit model was also used to quantify biomechanical changes and to gain physiological insight.

RESULTS AND DISCUSSION

The CF adults presented an increased total respiratory resistance (p < 0.0001), increased resistance curve slope (p<0.0006) and reduced dynamic compliance (p<0.0001). In close agreement with the physiology of CF, the model analysis showed increased peripheral resistance (p<0.0005) and reduced compliance (p < 0.0004) and inertance (p<0.005). Significant reasonable to good correlations were observed between the resistive parameters and spirometric and plethysmographic indexes. Similar associations were observed for the reactive parameters. Peripheral resistance, obtained by the model analysis, presented reasonable (R=0.35) to good (R=0.64) relationships with plethysmographic parameters.

CONCLUSIONS

The FOT adequately assessed the biomechanical changes associated with CF. The model used provides sensitive indicators of lung function and has the capacity to differentiate between obstructed and non-obstructed airway conditions. The FOT shows great potential for the clinical assessment of respiratory mechanics in adults with CF.

摘要

背景

强迫振荡技术(FOT)有潜力增加我们对囊性纤维化(CF)中发生的生物力学变化的了解。因此,本研究的目的是调查成年CF患者呼吸系统的阻力和反应特性变化。

方法

该研究对一组27名18岁以上的成年CF患者和一组23名健康个体进行,两组均通过FOT、体积描记法和肺活量测定法进行评估。还使用了等效电路模型来量化生物力学变化并获得生理学见解。

结果与讨论

成年CF患者表现出总呼吸阻力增加(p < 0.0001)、阻力曲线斜率增加(p < 0.0006)和动态顺应性降低(p < 0.0001)。与CF的生理学密切一致,模型分析显示外周阻力增加(p < 0.0005)、顺应性降低(p < 0.0004)和惯性降低(p < 0.005)。在阻力参数与肺活量测定和体积描记指标之间观察到显著的合理至良好相关性。反应参数也观察到类似的关联。通过模型分析获得的外周阻力与体积描记参数呈现合理(R = 0.35)至良好(R = 0.64)的关系。

结论

FOT充分评估了与CF相关的生物力学变化。所使用的模型提供了肺功能的敏感指标,并有能力区分阻塞性和非阻塞性气道状况。FOT在成年CF患者呼吸力学的临床评估中显示出巨大潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35b5/4334397/62900b3340ef/12938_2015_7_Fig1_HTML.jpg

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