肺残气量升高与气道疾病有关。

Isolated Elevation in Lung Residual Volume Is Associated With Airway Diseases.

机构信息

Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.

出版信息

Respir Care. 2022 Jul;67(7):842-849. doi: 10.4187/respcare.09687. Epub 2022 May 24.

DOI:10.4187/respcare.09687

PMID:35610031

Abstract

BACKGROUND

Residual volume (RV) is a derived lung compartment that correlates with air trapping in the context of air flow obstruction on spirometry. The significance of an isolated elevation in RV in the absence of other pulmonary function test (PFT) abnormalities is not well defined. We sought to assess the clinical and radiologic findings associated with isolated elevation in RV.

METHODS

We searched our out-patient PFT database at Mayo Clinic (Rochester, Minnesota) from 2016-2018 for adult patients with isolated elevation in RV. We defined isolated elevation in RV as RV ≥ upper limit of normal or ≥ 130% predicted with normal total lung capacity (TLC), spirometry, and diffusion capacity of the lung for carbon monoxide (D). We then matched this high-RV group by age and sex to an equal number of individuals with normal RV, TLC, spirometry, and D (normal-RV group).

RESULTS

We identified 169 subjects with isolated elevation in RV on PFTs, with a median age of 73 y; 55.6% were female, and median body mass index was 26.8 (vs 29.8 in the normal-RV group). The median RV was 3.08 L (134% predicted, interquartile range [IQR] 130-141) in the high-RV group and 2.26 L (99% predicted, IQR 90-109) in the normal-RV group < .001). Subjects with high RV were more likely to have smoked (54% vs 40%, = .01) and almost twice as likely to have a maximum voluntary ventilation < 30 times the FEV (21% vs 12%, = .02). Clinically, asthma (21% vs 11%, = .01) and non-tuberculous mycobacterial lung infections (12% vs 2%, = .001) were more prevalent in the high-RV group. On chest computed tomography, bronchiectasis (31% vs 15%, = .008), bronchial thickening or mucus plugging (46% vs 22%, < .001), and emphysema (13% vs 5%, = .046) were more common in the high-RV group.

CONCLUSIONS

Isolated elevation in RV on PFTs is a clinically relevant abnormality associated with airway-centered diseases.

摘要

背景

残气量（RV）是一个衍生的肺区，与肺功能测试（PFT）中气流阻塞时的空气捕获相关。在没有其他 PFT 异常的情况下，RV 单独升高的意义尚未明确。我们试图评估与 RV 单独升高相关的临床和影像学发现。

方法

我们在梅奥诊所（明尼苏达州罗切斯特）的门诊 PFT 数据库中，从 2016 年至 2018 年搜索了 RV 单独升高的成年患者。我们将 RV 单独升高定义为 RV≥正常上限或≥预计值的 130%，同时伴有正常的肺总量（TLC）、肺活量和一氧化碳弥散量（D）。然后，我们通过年龄和性别将 RV 升高组与 RV、TLC、肺活量和 D 正常组匹配，每组人数相等。

结果

我们在 PFT 中确定了 169 例 RV 单独升高的患者，中位年龄为 73 岁；55.6%为女性，中位体重指数为 26.8（与 RV 正常组的 29.8 相比）。RV 升高组的中位 RV 为 3.08L（预计值的 134%，四分位距 [IQR] 130-141），而 RV 正常组为 2.26L（预计值的 99%，IQR 90-109），<0.001）。RV 升高的患者更有可能吸烟（54% vs 40%，=0.01），并且更有可能出现最大自主通气量<30 倍的 FEV（21% vs 12%，=0.02）。临床上，哮喘（21% vs 11%，=0.01）和非结核分枝杆菌肺部感染（12% vs 2%，=0.001）在 RV 升高组更为常见。在胸部计算机断层扫描中，支气管扩张（31% vs 15%，=0.008）、支气管壁增厚或黏液栓（46% vs 22%，<0.001）和肺气肿（13% vs 5%，=0.046）在 RV 升高组更为常见。