Camilo G B, Carvalho A R S, Machado D C, Mogami R, Kasuki L, Gadelha M R, Melo P L, Lopes A J
Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR.
Laboratório de Fisiologia da Respiração, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR.
Braz J Med Biol Res. 2015 Oct;48(10):877-85. doi: 10.1590/1414-431X20154786. Epub 2015 Aug 4.
The aims of this study were to evaluate the forced oscillation technique (FOT) and pulmonary densitovolumetry in acromegalic patients and to examine the correlations between these findings. In this cross-sectional study, 29 non-smoking acromegalic patients and 17 paired controls were subjected to the FOT and quantification of lung volume using multidetector computed tomography (Q-MDCT). Compared with the controls, the acromegalic patients had a higher value for resonance frequency [15.3 (10.9-19.7) vs 11.4 (9.05-17.6) Hz, P=0.023] and a lower value for mean reactance [0.32 (0.21-0.64) vs 0.49 (0.34-0.96) cm H2O/L/s2, P=0.005]. In inspiratory Q-MDCT, the acromegalic patients had higher percentages of total lung volume (TLV) for nonaerated and poorly aerated areas [0.42% (0.30-0.51%) vs 0.25% (0.20-0.32%), P=0.039 and 3.25% (2.48-3.46%) vs 1.70% (1.45-2.15%), P=0.001, respectively]. Furthermore, the acromegalic patients had higher values for total lung mass in both inspiratory and expiratory Q-MDCT [821 (635-923) vs 696 (599-769) g, P=0.021 and 844 (650-945) vs 637 (536-736) g, P=0.009, respectively]. In inspiratory Q-MDCT, TLV showed significant correlations with all FOT parameters. The TLV of hyperaerated areas showed significant correlations with intercept resistance (rs=-0.602, P<0.001) and mean resistance (rs=-0.580, P<0.001). These data showed that acromegalic patients have increased amounts of lung tissue as well as nonaerated and poorly aerated areas. Functionally, there was a loss of homogeneity of the respiratory system. Moreover, there were correlations between the structural and functional findings of the respiratory system, consistent with the pathophysiology of the disease.
本研究的目的是评估肢端肥大症患者的强迫振荡技术（FOT）和肺密度容积测定，并检查这些结果之间的相关性。在这项横断面研究中，29名不吸烟的肢端肥大症患者和17名配对对照者接受了FOT检查，并使用多排螺旋计算机断层扫描（Q-MDCT）对肺容积进行了量化。与对照组相比，肢端肥大症患者的共振频率值更高[15.3（10.9 - 19.7）Hz对11.4（9.05 - 17.6）Hz，P = 0.023]，平均电抗值更低[0.32（0.21 - 0.64）cmH₂O/L/s²对0.49（0.34 - 0.96）cmH₂O/L/s²，P = 0.005]。在吸气期Q-MDCT中，肢端肥大症患者非充气和充气不良区域的总肺容积（TLV）百分比更高[分别为0.42%（0.30 - 0.51%）对0.25%（0.20 - 0.32%），P = 0.039和3.25%（2.48 - 3.46%）对1.70%（1.45 - 2.15%），P = 0.001]。此外，在吸气期和呼气期Q-MDCT中，肢端肥大症患者的总肺质量值均更高[分别为821（635 - 923）g对696（599 - 769）g，P = 0.021和844（650 - 945）g对637（536 - 736）g，P = 0.009]。在吸气期Q-MDCT中，TLV与所有FOT参数均显示出显著相关性。高充气区域的TLV与截距阻力（rs = -0.602，P < 0.001）和平均阻力（rs = -z0.580，P < 0.001）显示出显著相关性。这些数据表明，肢端肥大症患者的肺组织以及非充气和充气不良区域的数量增加。在功能上，呼吸系统失去了同质性。此外，呼吸系统的结构和功能结果之间存在相关性，这与该疾病的病理生理学一致。
