Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel.
Pediatric Radiology Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Lung. 2016 Dec;194(6):1007-1013. doi: 10.1007/s00408-016-9934-8. Epub 2016 Aug 31.
Bronchiolitis obliterans (BO) is a chronic airway disease following an insult to the lower respiratory tract. Lung clearance index (LCI) measures ventilation inhomogeneity and has been studied in cystic fibrosis (CF). We aimed to evaluate LCI in BO and to compare it to LCI in CF patients.
LCI was measured in BO patients, compared to CF patients, and correlated with spirometry and CT findings.
Twenty BO patients and 26 CF patients (with similar mean age and BMI) underwent evaluation. FEV1 % and FEF25-75 % predicted were significantly lower in the BO group (60.5 ± 17.8 vs. 72.7 ± 20.7, p = 0.041, and 42.8 ± 22.8 vs. 66.4 ± 37.4, p = 0.017, respectively). In both groups, LCI was inversely correlated with FVC %, FEV1 %, and FEF25-75 % predicted. LCI % was slightly higher (190.4 ± 63.5 vs. 164.9 ± 39.4, p = 0.1) and FRC gas % (measured by multiple breath washout) was significantly higher in the BO group (92.5 ± 35.9 vs. 71.3 ± 18, p = 0.014). The strength of statistical association between the lower FEF25-75 % values and the higher LCI values was stronger in BO patients.
Similar to CF, LCI may provide estimation of ventilation inhomogeneity in BO. The results indicate greater small airway involvement and air trapping in BO. Further prospective longitudinal studies evaluating the correlation of LCI measurements with multiple clinical and physiological parameters should be performed to assess the clinical benefit of LCI measurement in BO.
闭塞性细支气管炎（BO）是一种在下呼吸道受到损伤后引起的慢性气道疾病。肺清除指数（LCI）可衡量通气不均质性，在囊性纤维化（CF）中已有研究。我们旨在评估 BO 患者的 LCI，并将其与 CF 患者的 LCI 进行比较。
我们在 BO 患者中测量 LCI，与 CF 患者进行比较，并与肺功能和 CT 发现相关联。
共有 20 名 BO 患者和 26 名 CF 患者（平均年龄和 BMI 相似）接受了评估。BO 组的 FEV1%和 FEF25-75%预计值明显较低（60.5±17.8 对 72.7±20.7，p=0.041，42.8±22.8 对 66.4±37.4，p=0.017）。在两组中，LCI 与 FVC%、FEV1%和 FEF25-75%预计值呈负相关。LCI%略高（190.4±63.5 对 164.9±39.4，p=0.1），BO 组的功能残气气体%（通过多次呼吸冲洗测量）明显更高（92.5±35.9 对 71.3±18，p=0.014）。在 BO 患者中，较低的 FEF25-75%值与较高的 LCI 值之间的统计关联强度更强。
与 CF 类似，LCI 可能提供 BO 通气不均质性的估计。结果表明 BO 患者的小气道受累和空气滞留更严重。应进一步开展前瞻性纵向研究，评估 LCI 测量与多个临床和生理参数的相关性，以评估 LCI 测量在 BO 中的临床获益。
