Department of Pulmonology, University of Health Sciences, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Apr;27(7):3033-3044. doi: 10.26355/eurrev_202304_31937.
Small airway dysfunction is a pathological component of chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF), and impulse oscillometry is an easy-to-administer, effort-independent non-invasive test reflecting small airway dysfunction. We aimed to compare the impulse oscillometry (IOS) measurements between COPD and IPF patients and investigate their correlation with severity of both diseases and other conventional parameters.
This was a prospective, longitudinal study. We longitudinally evaluated the baseline demographic characteristics, COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) dyspnea scale, Pulmonary Function Test (PFT), Carbon Monoxide Diffusing Capacity (DLCO), Hemogram and Impulse Oscillometry measurements of the patients diagnosed with COPD and IPF.
The study included 60 IPF patients and 48 COPD patients. The CAT and mMRC scores were higher in COPD patients. The majority of COPD patients were classified into Category B (46%), while 68% of IPF patients had Stage 1 GAP. The mean FEF 25-75%, which is typically considered to reflect small airway disease, was 93% in IPF patients, while it was significantly lower in COPD patients (29%). Impulse oscillometry measurements were consistent with spirometry parameters. IOS resistance and reactance values were significantly higher in COPD patients than in IPF patients.
IOS is advantageous in COPD and IPF patients who cannot exhale due to severe dyspnea, as it is easy to administer and reflects small airway resistance better. Diagnosis of small airway dysfunction may be beneficial in the management of patients with IPF and COPD.
小气道功能障碍是慢性阻塞性肺疾病（COPD）和特发性肺纤维化（IPF）的病理组成部分，脉冲振荡法是一种易于实施、无需用力的非侵入性检测方法，可反映小气道功能障碍。我们旨在比较 COPD 和 IPF 患者的脉冲振荡法（IOS）测量值，并探讨其与两种疾病严重程度以及其他常规参数的相关性。
这是一项前瞻性、纵向研究。我们对诊断为 COPD 和 IPF 的患者进行了基线人口统计学特征、COPD 评估测试（CAT）和改良的医学研究委员会（mMRC）呼吸困难量表、肺功能测试（PFT）、一氧化碳弥散量（DLCO）、血常规和脉冲振荡法测量的纵向评估。
该研究纳入了 60 例 IPF 患者和 48 例 COPD 患者。COPD 患者的 CAT 和 mMRC 评分更高。大多数 COPD 患者被分类为 B 类（46%），而 68%的 IPF 患者处于 GAP 分期 1 期。通常认为反映小气道疾病的 25-75%用力呼气量（FEF25-75%）在 IPF 患者中为 93%，而在 COPD 患者中则显著降低（29%）。脉冲振荡法测量值与肺功能参数一致。IOS 阻力和电抗值在 COPD 患者中明显高于 IPF 患者。
在因严重呼吸困难而无法呼气的 COPD 和 IPF 患者中，IOS 具有优势，因为它易于实施并且更好地反映小气道阻力。诊断小气道功能障碍可能有益于 IPF 和 COPD 患者的管理。
