Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
PLoS One. 2023 Feb 7;18(2):e0280309. doi: 10.1371/journal.pone.0280309. eCollection 2023.
Impulse oscillometry system (IOS) is a simple, and less invasive method for assessing small to total airway resistance in children. We analyzed the correlation between IOS, spirometry, and plethysmographic parameters performed for the diagnosis of pediatric BO patients. A total of 89 IOS assessments of pediatric BO patients or children without lung disease were included, and the relationship between pulmonary function tests (PFTs) and diagnostic performance was analyzed. R5, R5-20, X5, and AX were statistically significantly worse in the BO group. In general linear correlation analysis, R5% (adjusted β [aβ], -0.59; p < 0.001) and AX % (aβ, -0.9; p < 0.001) showed the strongest correlation with conventional PFT parameters. R5% and AX % also showed the highest correlation with FEF25-75% (aβ, -0.48; p < 0.001 and aβ, -0.83; p < 0.001), and sRaw % (aβ, -0.73; p = 0.003 and aβ, -0.59; p = 0.008, respectively). Multivariate logistic regression analysis showed that R5 Z-score showed the highest ORs with FEV1 (OR = 3.94, p = 0.006), FEF25-75% (OR = 5.96, p = 0.005), and sRaw % (OR = 4.85, p = 0.022). Receiver operating curve analysis suggested AX % and R5% as the most optimal IOS parameters for BO diagnostic performance with the area under the curve of 0.915 and 0.882, respectively. In conclusion, R5 and AX are the parameters that can independently identify the severity of airway obstruction in pediatric BO patients without conventional lung function tests. IOS is an easy-to-perform, and reliable diagnostic method capable of detecting pathological obliteration of the small airways in children with BO.
脉冲震荡系统（IOS）是一种简单且微创的方法，可用于评估儿童的小气道至总气道阻力。我们分析了 IOS 与肺功能检查（PFT）和体描法参数在小儿闭塞性细支气管炎（BO）患者诊断中的相关性。共纳入 89 例小儿 BO 患者或无肺部疾病儿童的 IOS 评估，分析了肺功能检查（PFT）与诊断性能的关系。BO 组的 R5、R5-20、X5 和 AX 均有统计学意义上的显著降低。在一般线性相关分析中，R5%（调整β[aβ]，-0.59；p<0.001）和 AX%（aβ，-0.9；p<0.001）与常规 PFT 指标相关性最强。R5%和 AX%与 FEF25-75%（aβ，-0.48；p<0.001 和 aβ，-0.83；p<0.001）以及 sRaw%（aβ，-0.73；p=0.003 和 aβ，-0.59；p=0.008）相关性最强。多元逻辑回归分析显示，R5Z 评分与 FEV1（OR=3.94，p=0.006）、FEF25-75%（OR=5.96，p=0.005）和 sRaw%（OR=4.85，p=0.022）的相关性最高。受试者工作特征曲线分析提示 AX%和 R5%是用于 BO 诊断性能的最佳 IOS 参数，曲线下面积分别为 0.915 和 0.882。总之，R5 和 AX 是可以独立识别小儿 BO 患者气道阻塞严重程度的参数，无需进行常规肺功能检查。IOS 是一种易于实施且可靠的诊断方法，能够检测小儿 BO 患者小气道的病理闭塞。
