特发性肺纤维化中国患者的小气道功能障碍。
Small airway dysfunction in Chinese patients with idiopathic pulmonary fibrosis.
机构信息
Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, 100029, China.
Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine; National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100029, China.
出版信息
BMC Pulm Med. 2022 Aug 2;22(1):297. doi: 10.1186/s12890-022-02089-6.
BACKGROUND
Recent years, idiopathic pulmonary fibrosis (IPF) is thought to be a disease of alveoli as well as small airways. This study aimed to demonstrate the clinical feature, predictor, and prognosis of small airway dysfunction (SAD) in Chinese patients with IPF.
METHODS
We enrolled 416 patients with IPF who hospitalized in Beijing Chao-Yang Hospital from 2000 to 2014 in this study, and the follow-up ended at December 2016. We collected demographic information, clinical examination results, spirometry results, HRCT results, and blood gas results during the study. Logistic regression analysis was used to identify the predictor for SAD. The COX proportional hazard model was used to analysis the prognosis effect of SAD.
RESULTS
Among all the participants, 165 (39.66%) patients had SAD. FEV1 (% predicted) and FEV3/FVC were significantly associated with SAD in patients with IPF. IPF patients with lower FEV1 (% predicted, OR 30.04, 95% CI 9.61-93.90) and FEV3/FVC (OR 77.76, 95% CI 15.44-391.63) had increased risk for SAD. Patients with SAD were associated with significantly increased risk of mortality in patients with IPF (HR 1.73, 95% CI 1.02-2.92), as well as in IPF patients without other pulmonary comorbidities (COPD, emphysema, and asthma).
CONCLUSIONS
Spirometry-defined SAD was like 40% in patients with IPF. Lower FEV1 (% predicted) and FEV3/FVC were main predictors for SAD. IPF patients with SAD showed poorer prognosis.
背景
近年来，特发性肺纤维化（IPF）被认为是一种肺泡和小气道疾病。本研究旨在展示中国 IPF 患者小气道功能障碍（SAD）的临床特征、预测因素和预后。
方法
我们纳入了 2000 年至 2014 年期间在北京朝阳医院住院的 416 例 IPF 患者，随访至 2016 年 12 月。我们收集了研究期间的人口统计学信息、临床检查结果、肺量测定结果、高分辨率 CT 结果和血气结果。使用逻辑回归分析来确定 SAD 的预测因素。使用 COX 比例风险模型分析 SAD 的预后效果。
结果
在所有参与者中，有 165 例（39.66%）患者存在 SAD。FEV1（%预计值）和 FEV3/FVC 与 IPF 患者的 SAD 显著相关。FEV1（%预计值，OR 30.04，95%CI 9.61-93.90）和 FEV3/FVC（OR 77.76，95%CI 15.44-391.63）较低的 IPF 患者发生 SAD 的风险增加。患有 SAD 的患者与 IPF 患者的死亡率显著增加相关（HR 1.73，95%CI 1.02-2.92），也与没有其他肺部合并症（COPD、肺气肿和哮喘）的 IPF 患者相关。
结论
在 IPF 患者中，通过肺量测定定义的 SAD 约为 40%。较低的 FEV1（%预计值）和 FEV3/FVC 是 SAD 的主要预测因素。患有 SAD 的 IPF 患者预后较差。
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