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[慢性阻塞性肺疾病呼吸困难功能评估中的强迫振荡技术]

[The forced oscillation technique in the functional evaluation of COPD dyspnea].

作者信息

Ghilain Arnaud, Marchand Eric

机构信息

Service de pneumologie, CHU UCL Namur - Site Godinne, 5530 Yvoir, Belgique.

Service de pneumologie, CHU UCL Namur - Site Godinne, 5530 Yvoir, Belgique; Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Belgique; NAmur Research Institute for LIfe Sciences (NARILIS) et Unité de recherche en physiologie moléculaire (URPhyM), UNamur, 5000 Namur, Belgique.

出版信息

Rev Mal Respir. 2022 Oct;39(8):659-668. doi: 10.1016/j.rmr.2022.08.001. Epub 2022 Aug 28.

Abstract

INTRODUCTION

The goal of the present study is to assess the relationship between functional respiratory parameters measured by the forced oscillation technique (FOT) in COPD patients and (1) dyspnea; (2) inspiratory capacity (IC), along with the variations occurring subsequent to bronchodilation.

METHODS

This cross-sectional study analyzed 40 stable COPD patients. Dyspnea was assessed by means of the San Diego Shortness of Breath Questionnaire. Forced oscillations were measured before and after bronchodilation by means of routine pulmonary function tests (PFTs).

RESULTS

The reactance parameters measured by the FOT correlated with dyspnea (AX5: r=0.46; P=0.003) similarly to IC (r=-0.46; P=0.003). Changes in AX5 following bronchodilation led to a predicted 12% and 200mL improvement in IC, AX5 (area under the ROC curve=0.85, P<0.001).

CONCLUSIONS

Forced oscillation technique (FOT) appears to be an interesting complement to routine PFTs in COPD assessment. Reactance parameters are correlated with dyspnea and their response to bronchodilators is a predictor of significantly improved inspiratory capacity (IC). All in all, FOT may be considered as a functional test with regard to pulmonary hyperinflation, a critical determinant of dyspnea.

摘要

引言

本研究的目的是评估慢性阻塞性肺疾病(COPD)患者通过强迫振荡技术(FOT)测量的功能性呼吸参数与(1)呼吸困难;(2)吸气容量(IC)之间的关系,以及支气管扩张后发生的变化。

方法

这项横断面研究分析了40例稳定期COPD患者。通过圣地亚哥呼吸急促问卷评估呼吸困难。通过常规肺功能测试(PFT)在支气管扩张前后测量强迫振荡。

结果

FOT测量的电抗参数与呼吸困难相关(AX5:r = 0.46;P = 0.003),与IC相似(r = -0.46;P = 0.003)。支气管扩张后AX5的变化导致IC、AX5预测改善12%和200mL(ROC曲线下面积 = 0.85,P < 0.001)。

结论

强迫振荡技术(FOT)似乎是COPD评估中常规PFT的一个有趣补充。电抗参数与呼吸困难相关,它们对支气管扩张剂的反应是吸气容量(IC)显著改善的预测指标。总而言之,FOT可被视为一种关于肺过度充气的功能测试,肺过度充气是呼吸困难的关键决定因素。

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