在弥漫性实质性肺疾病患者中，对于相同的DLCO值存在不同的KCO和VA组合。
Different KCO and VA combinations exist for the same DLCO value in patients with diffuse parenchymal lung diseases.
作者信息
Pastre Jean, Plantier Laurent, Planes Carole, Borie Raphaël, Nunes Hilario, Delclaux Christophe, Israël-Biet Dominique
机构信息
Université Paris Descartes, Sorbonne Paris Cité and AP-HP, Service de Pneumologie, Hôpital Européen Georges Pompidou, Paris, France.
Université Paris Diderot, Sorbonne Paris Cité and AP-HP, Service de Physiologie, Hôpital Bichat-Claude Bernard, Paris, France.
出版信息
BMC Pulm Med. 2015 Sep 3;15:100. doi: 10.1186/s12890-015-0084-1.
BACKGROUND
DLCO is the product of the CO transfer coefficient (KCO) by the "accessible" alveolar volume (VA). In theory, the same DLCO may result from various combinations of KCO and VA values, each of which reflect different injury sites and mechanisms. We sought to determine in this study the potential variability of both VA and KCO for fixed values of DLCO in diffuse parenchymal lung diseases (DPLD).
METHODS
To this end, we designed a retrospective, cross-sectional study of three distinct types of DPLD and analysed pulmonary function test (PFT) datasets.
RESULTS
We show here that for the same value of DLCO (50% predicted), KCO varied from 60 to 95% predicted and VA from 55 to 85% predicted in various types of DPLD idiopathic pulmonary fibrosis, sarcoidosis and connective tissue disease-associated DPLD, indicating distinct pathogenic mechanisms in these diseases. In addition, a comparison of VA with total lung capacity may help to evidence the distal airway obstruction sometimes associated with certain DPLD particularly sarcoidosis.
CONCLUSION
Clinicians should take into account not only DLCO but also VA and KCO values when managing patients with DPLD.
背景
一氧化碳弥散量（DLCO）是一氧化碳转运系数（KCO）与“可及”肺泡容积（VA）的乘积。理论上，相同的DLCO可能由KCO和VA值的各种组合导致，其中每一种组合都反映了不同的损伤部位和机制。在本研究中，我们试图确定弥漫性肺实质疾病（DPLD）中固定DLCO值时VA和KCO的潜在变异性。
方法
为此，我们设计了一项对三种不同类型DPLD的回顾性横断面研究，并分析了肺功能测试（PFT）数据集。
结果
我们在此表明，对于相同的DLCO值（预测值的50%），在特发性肺纤维化、结节病和结缔组织病相关的DPLD等各种类型的DPLD中，KCO从预测值的60%变化到95%，VA从预测值的55%变化到85%，这表明这些疾病中存在不同的致病机制。此外，将VA与肺总量进行比较可能有助于证明有时与某些DPLD特别是结节病相关的远端气道阻塞。
结论
临床医生在管理DPLD患者时不仅应考虑DLCO，还应考虑VA和KCO值。
Zotero 插件