Institute of Inflammation and Ageing University of Birmingham, Edgbaston, Birmingham, UK.
Respiratory Therapy Department, College of Applied Medical Sciences, King Saud Bin Abdul-Aziz University for Health Sciences, Al Ahsa, Saudi Arabia.
COPD. 2020 Dec;17(6):711-720. doi: 10.1080/15412555.2020.1815183. Epub 2020 Nov 12.
Exacerbations are prevalent in Chronic Obstructive Pulmonary Disease (COPD) patients and associated with poor clinical outcomes. Currently, there is a lack of sensitive and specific tools that can objectively identify exacerbations and assess their progress or treatment response. FEV is often reported as a study outcome, but it has significant limitations. Studies have suggested that small airways measures might provide physiological biomarkers during exacerbations. Therefore, this study was done to assess which physiological tests of small airways function have been used in the acute setting during exacerbations of COPD and the evidence to support their use. An electronic databases search was conducted in April 2019. A standard systematic review methodology was used. Eligible studies were those of ≥10 participants that compared at least one small airway test with FEV to assess response to treatment with baseline and a follow-up measurement ≤2 months after. Analyses were narrative. Of 1436 screened studies, seven studies were eligible. There was heterogeneity in which tests of small airways were used and three different small airways measures were reported. Studies were small (including 20 to 87 subjects). Six articles reported improvements in small airway measurements during the recovery from exacerbation which correlated with FEV. Included studies varied in their timing and duration of the assessment. There is some evidence to support the use of small airway tests in acute exacerbations of COPD. However, studies have been small with different tests being utilized. Further studies to determine the usefulness of each test may be of interest.
加重期在慢性阻塞性肺疾病（COPD）患者中很常见，并且与不良的临床结局相关。目前，缺乏能够客观识别加重期并评估其进展或治疗反应的敏感和特异工具。FEV 通常被报道为研究结果，但它有显著的局限性。研究表明，小气道测量可能在加重期提供生理生物标志物。因此，这项研究旨在评估在 COPD 加重期的急性情况下，哪些小气道功能的生理测试已被用于评估，以及支持其使用的证据。2019 年 4 月进行了电子数据库检索。采用标准系统评价方法。符合条件的研究是指≥10 名参与者的研究，这些研究比较了至少一种小气道测试与 FEV，以评估与基线相比治疗的反应，随访测量时间在加重期后≤2 个月。分析为叙述性。在筛选的 1436 项研究中，有 7 项研究符合条件。所使用的小气道测试存在异质性，报告了三种不同的小气道测量方法。研究规模较小（包括 20 至 87 名受试者）。六篇文章报告了在加重期恢复过程中小气道测量的改善，这与 FEV 相关。纳入的研究在评估的时间和持续时间上存在差异。有一些证据支持在 COPD 的急性加重期使用小气道测试。然而，研究规模较小，使用了不同的测试。进一步研究每种测试的有用性可能会很有意义。
