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在健康城市人群中使用脉冲振荡法测量呼吸阻抗。

Respiratory impedance measured using impulse oscillometry in a healthy urban population.

作者信息

Berger Kenneth I, Wohlleber Margaret, Goldring Roberta M, Reibman Joan, Farfel Mark R, Friedman Stephen M, Oppenheimer Beno W, Stellman Steven D, Cone James E, Shao Yongzhao

机构信息

Dept of Medicine, NYU Grossman School of Medicine, New York, NY, USA.

André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA.

出版信息

ERJ Open Res. 2021 Mar 29;7(1). doi: 10.1183/23120541.00560-2020. eCollection 2021 Jan.

Abstract

This study derives normative prediction equations for respiratory impedance in a healthy asymptomatic urban population using an impulse oscillation system (IOS). In addition, this study uses body mass index (BMI) in the equations to describe the effect of obesity on respiratory impedance. Data from an urban population comprising 472 healthy asymptomatic subjects that resided or worked in lower Manhattan, New York City were retrospectively analysed. This population was the control group from a previously completed case-control study of the health effects of exposure to World Trade Center dust. Since all subjects underwent spirometry and oscillometry, these previously collected data allowed a unique opportunity to derive normative prediction equations for oscillometry in an urban, lifetime non-smoking, asymptomatic population without underlying respiratory disease. Normative prediction equations for men and women were successfully developed for a broad range of respiratory oscillometry variables with narrow confidence bands. Models that used BMI as an independent predictor of oscillometry variables (in addition to age and height) demonstrated equivalent or better fit when compared with models that used weight. With increasing BMI, resistance and reactance increased compatible with lung and airway compression from mass loading. This study represents the largest cohort of healthy urban subjects assessed with an IOS device. Normative prediction equations were derived that should facilitate application of IOS in the clinical setting. In addition, the data suggest that modelling of lung function may be best performed using height and BMI as independent variables rather than the traditional approach of using height and weight.

摘要

本研究使用脉冲振荡系统(IOS)得出了健康无症状城市人群呼吸阻抗的规范预测方程。此外,本研究在方程中使用体重指数(BMI)来描述肥胖对呼吸阻抗的影响。对居住或工作在纽约市曼哈顿下城的472名健康无症状受试者的城市人群数据进行了回顾性分析。该人群是先前完成的一项关于接触世贸中心灰尘对健康影响的病例对照研究的对照组。由于所有受试者都进行了肺活量测定和振荡测定,这些先前收集的数据提供了一个独特的机会,可得出城市中终生不吸烟、无症状且无潜在呼吸系统疾病人群的振荡测定规范预测方程。成功地为广泛的呼吸振荡测定变量建立了男性和女性的规范预测方程,其置信区间较窄。与使用体重的模型相比,将BMI作为振荡测定变量的独立预测因子(除年龄和身高外)的模型显示出同等或更好的拟合度。随着BMI的增加,阻力和电抗增加,这与质量负荷导致的肺和气道受压相符。本研究代表了使用IOS设备评估的最大一组健康城市受试者。得出的规范预测方程应有助于IOS在临床环境中的应用。此外,数据表明,使用身高和BMI作为自变量对肺功能进行建模可能比使用身高和体重的传统方法更为合适。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8eae/8005688/bac3928e9af8/00560-2020.01.jpg

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