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慢性阻塞性肺疾病患者可以准确进行基于家庭的吸气量和动态过度充气测量。

Patients with Chronic Obstructive Pulmonary Disease Can Accurately Perform Home-Based Measurements of Inspiratory Capacity and Dynamic Hyperinflation.

机构信息

Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.

出版信息

COPD. 2022 Apr 27;19(1):236-242. doi: 10.1080/15412555.2022.2069554.

Abstract

Home-based lung function measurements can be used to capture day-to-day variations in symptoms in patients with chronic obstructive pulmonary disease (COPD). Although dynamic hyperinflation (DH) is clinically relevant, existing home-based measurements do not include its assessment. DH can be measured through inspiratory capacity (IC) measurements before and after metronome-paced tachypnea test (MPT). The goal of this study is to determine the accuracy of unsupervised home-based IC and DH measurements in COPD.Sixteen COPD patients performed IC and DH measurements during 4 home visits. Visit 1 was considered a training session. During all visits supervised and unsupervised IC at rest (IC) and after MPT (IC) were measured. DH was calculated as the difference between IC and IC, and as a percentage of IC. Bland-Altman analyses and ANOVA tests were performed to determine the effect of supervision and repeated measures over time.The biases between supervised and unsupervised IC, IC, ΔIC and ΔIC% were 0.007 L, 0.007 L, 0 mL and -0.09% in the last visit, respectively. Limits of agreement of IC and ΔIC% decreased from ±0.261 mL to ±0.201 mL, and from ±13.84% to ±10.81% between visit 1 and 4, respectively. No significant effect of supervision or over time was found.After a robust training and a learning phase, COPD patients are able to perform IC measurements in an accurate manner in both rest and after MPT. This yield accurate assessment of DH, in an unsupervised home-based setting.

摘要

家庭肺功能测量可用于捕捉慢性阻塞性肺疾病(COPD)患者日常症状的变化。虽然动态过度充气(DH)具有临床相关性,但现有的家庭测量方法并未包括其评估。DH 可通过测功计-paced 呼吸急促试验(MPT)前后的吸气量(IC)测量来测量。本研究的目的是确定在 COPD 患者中,非监督家庭基础 IC 和 DH 测量的准确性。16 名 COPD 患者在家中进行了 4 次访问,进行了 IC 和 DH 测量。第一次访问被认为是培训课程。在所有访问中,均测量了休息时的监督和非监督 IC(IC)以及 MPT 后 IC(IC)。DH 被定义为 IC 与 IC 之间的差异,并以 IC 的百分比表示。进行了 Bland-Altman 分析和 ANOVA 检验,以确定监督和随时间重复测量的效果。最后一次访问时,监督和非监督 IC、IC、ΔIC 和 ΔIC%之间的偏差分别为 0.007 L、0.007 L、0 mL 和-0.09%。IC 和 ΔIC%的一致性界限从 ±0.261 mL 分别减少到 ±0.201 mL,从 ±13.84%减少到 ±10.81%,从第 1 次访问到第 4 次访问。未发现监督或随时间变化的显着影响。经过严格的培训和学习阶段后,COPD 患者能够以准确的方式在休息和 MPT 后进行 IC 测量。这在非监督的家庭环境中可准确评估 DH。

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