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脉冲振荡法系统作为慢性阻塞性肺疾病的一种替代诊断方法。

Impulse oscillometry system as an alternative diagnostic method for chronic obstructive pulmonary disease.

作者信息

Wei Xia, Shi Zhihong, Cui Yajuan, Mi Jiuyun, Ma Zhengquan, Ren Jingting, Li Jie, Xu Shudi, Guo Youmin

机构信息

aDepartment of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University bDepartment of Respiratory Medicine, the Ninth Hospital of Xi'an Affiliated Hospital of Xi'an Jiaotong University cDepartment of Respiratory Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(46):e8543. doi: 10.1097/MD.0000000000008543.

Abstract

UNLABELLED

We aimed to compare impulse oscillation system (IOS) and traditional pulmonary function tests (PFTs) for the assessment of the severity of chronic obstructive pulmonary disease (COPD), and to assess the use of IOS parameters to identify patients who were forced expiratory volume in 1 second (FEV1)%pred < 50%.Patients with COPD (n = 215) were enrolled at the Ninth Hospital of Xi'an Affiliated Hospital of Xi'an Jiaotong University between October 2014 and September 2016. All patients were assessed by traditional PFT and IOS. Diagnostic performance of IOS parameters to determine indication for patients of FEV1%pred < 50% was assessed on receiver-operating characteristics (ROC) curve analysis.Out of 215 patients, 18, 83, 78, and 36 patients were classified as grade 1, 2, 3, and 4, respectively, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity grading. On Spearman correlation analysis, FEV1%pred, MMEF 75%-25%, and residual volume/total lung capacity (RV/TLC) correlated with total respiratory impedance (Z5)%pred, resistance at 5 Hz (R5)-resistance at 20 Hz (R20), R5-R20% R5, R5, R5%pred, frequency response (Fres), reactance area (Ax), and reactance at 5 Hz (X5). On ROC curve analysis, the area under the curve (AUC) of X5 absolute value, Fres, Ax, Z5%pred, R5-R20, and R5-R20% R5 were 0.748, 0.755, 0.760, 0.705, 0.715, and 0.735, respectively, for COPD patients who required inhalational glucocorticoid therapy.IOS parameters showed a good correlation with traditional pulmonary function parameters; reactance parameters showed a stronger correlation than that of the resistance parameters. IOS can be used as an alternative method for pulmonary function assessment in patients with COPD with FEV1%pred < 50% who need inhalational glucocorticoid therapy.

CLINICAL TRIAL REGISTRATION NUMBER

ChiCTR-OCH-14004904.

摘要

未标注

我们旨在比较脉冲振荡系统(IOS)和传统肺功能测试(PFT)对慢性阻塞性肺疾病(COPD)严重程度的评估,并评估使用IOS参数来识别1秒用力呼气量(FEV1)%预计值<50%的患者。2014年10月至2016年9月期间,在西安交通大学附属西安市第九医院招募了COPD患者(n = 215)。所有患者均接受传统PFT和IOS评估。通过受试者操作特征(ROC)曲线分析评估IOS参数对确定FEV1%预计值<50%患者的诊断性能。

在215例患者中,根据慢性阻塞性肺疾病全球倡议(GOLD)严重程度分级,分别有18、83、78和36例患者被分类为1、2、3和4级。在Spearman相关性分析中,FEV1%预计值、最大呼气中期流速(MMEF)75%-25%以及残气量/肺总量(RV/TLC)与总呼吸阻抗(Z5)%预计值、5Hz时的阻力(R5)-20Hz时的阻力(R20)、R5-R20%R5、R5、R5%预计值、频率响应(Fres)、电抗面积(Ax)以及5Hz时的电抗(X5)相关。在ROC曲线分析中,对于需要吸入糖皮质激素治疗的COPD患者,X5绝对值、Fres、Ax、Z5%预计值、R5-R20以及R5-R20%R5的曲线下面积(AUC)分别为0.748、0.755、0.760、0.705、0.715和0.735。

IOS参数与传统肺功能参数显示出良好的相关性;电抗参数显示出比阻力参数更强的相关性。对于需要吸入糖皮质激素治疗且FEV1%预计值<50%的COPD患者,IOS可作为肺功能评估的替代方法。

临床试验注册号

ChiCTR-OCH-14004904。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8488/5704804/d8671aeb9269/medi-96-e8543-g001.jpg

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