Scottish Centre for Respiratory Research, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, DD1 9SY, Scotland, UK.
Lung. 2022 Jun;200(3):301-303. doi: 10.1007/s00408-022-00542-1. Epub 2022 Jun 3.
Forced vital capacity (FVC) is often preserved in severe asthma unless there is evidence of either airway remodelling or air trapping. Area under the reactance curve (AX) can be used to assess small airways dysfunction related lung stiffness and is related to disease control in severe asthma.
We explore if there may be a potential synergistic interaction between FVC and AX in terms of impaired asthma control as ACQ and exacerbations requiring oral corticosteroids (OCS). We pragmatically defined < 100% and ≥ 1.0 kPa/L/s as impaired FVC or AX, respectively.
Patients with combined impairment of FVC and AX had significantly worse asthma control as higher ACQ, more severe exacerbations requiring OCS and worse spirometry (FEV and FEF) than those with impaired FVC but preserved AX.
This in turn supports using both spirometry and oscillometry to characterise airway physiology more comprehensively in patients with more severe asthma.
在严重哮喘中，用力肺活量（FVC）通常得以保留，除非存在气道重塑或空气滞留的证据。电抗曲线下面积（AX）可用于评估与小气道功能障碍相关的肺僵硬，并与严重哮喘的疾病控制相关。
我们探讨 FVC 和 AX 是否可能在哮喘控制方面存在潜在的协同作用，表现为 ACQ 和需要口服皮质类固醇（OCS）的加重。我们实用地定义了<100%和≥1.0 kPa/L/s 分别为 FVC 或 AX 受损。
与仅存在 FVC 受损而 AX 正常的患者相比，同时存在 FVC 和 AX 受损的患者的哮喘控制明显更差，ACQ 更高，需要 OCS 治疗的严重加重更多，肺功能（FEV 和 FEF）更差。
这反过来支持使用肺量计和振荡法更全面地描述更严重哮喘患者的气道生理学。
