呼吸力学强迫振荡技术（FOT）测量的阻力与支气管热成形术的反应相关。
Resistance of the respiratory system measured with forced oscillation technique (FOT) correlates with bronchial thermoplasty response.
机构信息
Department of Respiratory Medicine. F5-144, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Department of Respiratory Medicine, Leiden University Medical Center, Leiden, the Netherlands.
出版信息
Respir Res. 2020 Feb 12;21(1):52. doi: 10.1186/s12931-020-1313-6.
BACKGROUND
Bronchial Thermoplasty (BT) is an endoscopic treatment for severe asthma using radiofrequency energy to target airway remodeling including smooth muscle. The correlation of pulmonary function tests and BT response are largely unknown. Forced Oscillation Technique (FOT) is an effort-independent technique to assess respiratory resistance (Rrs) by using pressure oscillations including small airways.
AIM
To investigate the effect of BT on pulmonary function, assessed by spirometry, bodyplethysmography and FOT and explore associations between pulmonary function parameters and BT treatment response.
METHODS
Severe asthma patients recruited to the TASMA trial were analyzed in this observational cohort study. Spirometry, bodyplethysmography and FOT measurements were performed before and 6 months after BT. Asthma questionnaires (AQLQ/ACQ-6) were used to assess treatment response.
RESULTS
Twenty-four patients were analyzed. AQLQ and ACQ improved significantly 6 months after BT (AQLQ 4.15 (±0.96) to 4.90 (±1.14) and ACQ 2.64 (±0.60) to 2.11 (±1.04), p = 0.004 and p = 0.02 respectively). Pulmonary function parameters remained stable. Improvement in FEV correlated with AQLQ change (r = 0.45 p = 0.03). Lower respiratory resistance (Rrs) at baseline (both 5 Hz and 19 Hz) significantly correlated to AQLQ improvement (r = - 0.52 and r = - 0.53 respectively, p = 0.01 (both)). Borderline significant correlations with ACQ improvement were found (r = 0.30 p = 0.16 for 5 Hz and r = 0.41 p = 0.05 for 19 Hz).
CONCLUSION
Pulmonary function remained stable after BT. Improvement in FEV correlated with asthma questionnaires improvement including AQLQ. Lower FOT-measured respiratory resistance at baseline was associated with favorable BT response, which might reflect targeting of larger airways with BT.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02225392; Registered 26 August 2014.
背景
支气管热成形术（BT）是一种使用射频能量治疗严重哮喘的内镜治疗方法，旨在针对气道重塑（包括平滑肌）。肺功能测试与 BT 反应的相关性尚不清楚。呼吸强迫震荡技术（FOT）是一种无需用力的技术，通过使用包括小气道在内的压力震荡来评估呼吸阻力（Rrs）。
目的
研究 BT 对肺功能的影响，通过肺活量计、体描法和 FOT 进行评估，并探讨肺功能参数与 BT 治疗反应之间的关系。
方法
对 TASMA 试验中招募的严重哮喘患者进行了这项观察性队列研究。在 BT 前后 6 个月进行了肺活量计、体描法和 FOT 测量。使用哮喘问卷（AQLQ/ACQ-6）评估治疗反应。
结果
对 24 例患者进行了分析。BT 后 6 个月，AQLQ 和 ACQ 显著改善（AQLQ 从 4.15（±0.96）改善至 4.90（±1.14），ACQ 从 2.64（±0.60）改善至 2.11（±1.04），p=0.004 和 p=0.02）。肺功能参数保持稳定。FEV 的改善与 AQLQ 变化相关（r=0.45，p=0.03）。基线时较低的呼吸阻力（Rrs）（5 Hz 和 19 Hz 均）与 AQLQ 改善显著相关（r=-0.52 和 r=-0.53，p=0.01（均））。与 ACQ 改善有显著相关性（r=0.30，p=0.16，5 Hz；r=0.41，p=0.05，19 Hz）。
结论
BT 后肺功能保持稳定。FEV 的改善与包括 AQLQ 在内的哮喘问卷的改善相关。基线时较低的 FOT 测量呼吸阻力与 BT 的良好反应相关，这可能反映了 BT 对较大气道的靶向作用。
试验注册
ClinicalTrials.gov 标识符：NCT02225392；注册于 2014 年 8 月 26 日。
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