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支气管哮喘的肺部听诊与气道炎症

Lung Sound Analysis and Airway Inflammation in Bronchial Asthma.

机构信息

Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan.

Second Department of Internal Medicine, School of Medicine, Nagasaki University, Nagasaki, Japan.

出版信息

J Allergy Clin Immunol Pract. 2016 May-Jun;4(3):505-11. doi: 10.1016/j.jaip.2016.02.001. Epub 2016 Mar 25.

Abstract

BACKGROUND

Our previous study on lung sound analysis (LSA) revealed that the expiration-to-inspiration sound power ratio in a low-frequency range (E/I LF) was increased in patients with bronchial asthma, even when they have no wheezes.

OBJECTIVE

We also monitored the expiration-to-inspiration sound power ratio in a mid-frequency range (E/I MF) and the mid- to low-frequency sound power ratio for inspiration and expiration (ie, I MF/LF and E MF/LF, respectively) using a new software program to examine which parameter is most suitable as an index of airway inflammation in patients with asthma.

METHODS

A study was conducted in 31 patients with mild-to-moderate bronchial asthma to examine potential correlations of LSA parameters (E/I LF, E/I MF, I MF/LF, and E MF/LF) with spirogram parameters, airway hyperresponsiveness (PC20), fractional exhaled nitric oxide (NO), and sputum eosinophils.

RESULTS

E/I LF was significantly correlated with airway narrowing (forced expiratory volume in 1 second [FEV1.0]/forced vital capacity [FVC]%: r = -0.50, maximal expiratory flow at 50% [V50],%pred: r = -0.50) and peripheral airway inflammation (alveolar NO: r = 0.36, eosinophils in peripheral sputum: r = 0.41). E/I MF was significantly correlated with airway narrowing (FEV1.0/FVC%: r = -0.46, V50,%pred: r = -0.49), airway inflammation (bronchial NO: r = 0.43, alveolar NO: r = 0.47, eosinophils in peripheral sputum: r = 0.50), and airway hyperresponsiveness (logPC20: r = -0.49). E MF/LF was significantly correlated with airway inflammation (NO: r = 0.36, eosinophils in sputum: r = 0.40) and airway hyperresponsiveness (logPC20: r = -0.40). I MF/LF was not significantly correlated with any parameters.

CONCLUSIONS

Among the 4 LSA parameters investigated, E/I MF demonstrated the highest correlation with airway inflammation, and also with bronchial hyperresponsiveness.

摘要

背景

我们之前的肺部声音分析(LSA)研究表明,支气管哮喘患者的低频呼气与吸气声能比(E/I LF)增加,即使他们没有喘息。

目的

我们还使用新的软件程序监测了中频频域的呼气与吸气声能比(E/I MF)以及吸气和呼气的中低频声能比(即 I MF/LF 和 E MF/LF),以检查哪种参数最适合作为哮喘患者气道炎症的指标。

方法

对 31 名轻中度支气管哮喘患者进行了一项研究,以检查 LSA 参数(E/I LF、E/I MF、I MF/LF 和 E MF/LF)与肺活量测定参数、气道高反应性(PC20)、呼气一氧化氮分数(NO)和痰中嗜酸性粒细胞之间的潜在相关性。

结果

E/I LF 与气道狭窄(1 秒用力呼气量[FEV1.0]/用力肺活量[FVC]%:r = -0.50,50%最大呼气流量[V50],%预测值:r = -0.50)和周围气道炎症(肺泡 NO:r = 0.36,外周痰中嗜酸性粒细胞:r = 0.41)显著相关。E/I MF 与气道狭窄(FEV1.0/FVC%:r = -0.46,V50,%预测值:r = -0.49)、气道炎症(支气管 NO:r = 0.43,肺泡 NO:r = 0.47,外周痰中嗜酸性粒细胞:r = 0.50)和气道高反应性(logPC20:r = -0.49)显著相关。E MF/LF 与气道炎症(NO:r = 0.36,痰中嗜酸性粒细胞:r = 0.40)和气道高反应性(logPC20:r = -0.40)显著相关。I MF/LF 与任何参数均无显著相关性。

结论

在所研究的 4 个 LSA 参数中,E/I MF 与气道炎症相关性最高,与支气管高反应性也相关性最高。

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