Slebos Dirk-Jan, Hartman Jorine E, Klooster Karin, Blaas Stefan, Deslee Gaetan, Gesierich Wolfgang, Hetzel Juergen, Hetzel Martin, McNulty William, Kemp Samuel V, Kessler Romain, Leroy Sylvie, Stanzel Franz, Witt Christian, Zoumot Zaid, Herth Felix J F, Shah Pallav L
Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Respiration. 2015;90(2):136-45. doi: 10.1159/000431384. Epub 2015 Jun 25.
Bronchoscopic coil treatment has been shown to improve pulmonary function, exercise capacity, and quality of life in patients with severe emphysema.
To perform a meta-analysis of the results of four independent European clinical trials investigating this coil therapy for emphysema.
Data on all patients included in the four European clinical trials were analyzed for efficacy and safety outcomes.
A total of 2,536 coils were placed during 259 procedures in 140 patients. A total of 37 chronic obstructive pulmonary disease exacerbations and 27 pneumonias were recorded as serious adverse events up to 1 year after treatment. The pneumothorax rate was 6.4%. Both 6 and 12 months after treatment, significant (all p < 0.001) improvements were observed for: forced expiratory volume in 1 s [+0.08 liters (±0.19) and +0.08 liters (±0.21)], residual volume [RV; -510 ml (±850) and -430 ml (±720)], 6-min walking distance [6MWD; +44.1 m (±69.8) and +38.1 m (±71.9)], and St. George's Respiratory Questionnaire score [SGRQ; -9.5 points (±14.3) and -7.7 points (±14.2)]. No differences in any outcome measures were observed between heterogeneous and homogeneous emphysema patients. Only a high baseline RV was found to be an independent predictor of successful treatment.
Bronchoscopic coil treatment improves pulmonary function, 6MWD, and quality of life in patients with severe emphysema up to 1 year after treatment, independent of the distribution of the disease.
支气管镜下线圈治疗已被证明可改善重度肺气肿患者的肺功能、运动能力和生活质量。
对四项独立的欧洲临床试验结果进行荟萃分析，这些试验研究了这种用于肺气肿的线圈疗法。
分析四项欧洲临床试验中所有患者的数据，以评估疗效和安全性结果。
在140例患者的259次手术中总共放置了2536个线圈。治疗后长达1年，共记录到37次慢性阻塞性肺疾病加重和27例肺炎为严重不良事件。气胸发生率为6.4%。治疗后6个月和12个月时，观察到以下指标有显著改善（所有p<0.001）：第1秒用力呼气量[增加0.08升（±0.19）和0.08升（±0.21）]、残气量[RV；减少510毫升（±850）和430毫升（±720）]、6分钟步行距离[6MWD；增加44.1米（±69.8）和38.1米（±71.9）]以及圣乔治呼吸问卷评分[SGRQ；降低9.5分（±14.3）和7.7分（±14.2）]。在异质性和同质性肺气肿患者之间，未观察到任何结局指标存在差异。仅发现高基线RV是治疗成功的独立预测因素。
支气管镜下线圈治疗可改善重度肺气肿患者治疗后长达1年的肺功能、6MWD和生活质量，且与疾病分布无关。
