Wojsyk-Banaszak Irena, Stachowiak Zuzanna, Więckowska Barbara, Andrzejewska Marta, Tąpolska-Jóźwiak Katarzyna, Szczepankiewicz Aleksandra, Sobkowiak Paulina, Bręborowicz Anna
Department of Paediatric Pulmonology, Allergy and Clinical Immunology, Poznan University of Medical Sciences, 60-572 Poznan, Poland.
Molecular and Cell Biology Unit, Department of Paediatric Pulmonology, Allergy and Clinical Immunology, Poznan University of Medical Sciences, 60-572 Poznan, Poland.
Diagnostics (Basel). 2023 Jul 11;13(14):2336. doi: 10.3390/diagnostics13142336.
Recently, the most commonly used for multiple breath washout device, the Exhalyzer D, has been shown to overestimate lung clearance index (LCI) results due to a software error. Our study aimed to compare the predictive values of LCI in the CF pulmonary exacerbations (PE) calculated with the updated (3.3.1) and the previous (3.2.1) version of the Spiroware software. The measurements were performed during 259 visits in CF pediatric patients. We used 39ΔPE pairs (PE preceded by stable visit) and 138ΔS pairs (stable visit preceded by stable visit) to compare the LCI changes during PE. The areas under the receiver operating curves (AUC) and odds ratios were calculated based on the differences between ΔPEs and ΔSs. The exacerbation risk was estimated using a logistic regression model with generalized estimating equations (GEE). There were statistically significant differences in LCI 2.5% median values measured using the two versions of the software in the stable condition but not during PE. The AUC for changes between the two consecutive visits for LCI did not change significantly using the updated Spiroware software. Despite the lower median values, using the recalculated LCI values does not influence the diagnostic accuracy of this parameter in CF PE.
最近，最常用的多次呼气洗脱装置Exhalyzer D已被证明，由于软件错误，会高估肺清除指数（LCI）结果。我们的研究旨在比较使用更新版（3.3.1）和旧版（3.2.1）Spiroware软件计算的LCI在囊性纤维化肺部加重期（PE）中的预测价值。对259例囊性纤维化儿科患者进行了测量。我们使用39对ΔPE（PE前有稳定期就诊）和138对ΔS（稳定期就诊前有稳定期就诊）来比较PE期间的LCI变化。基于ΔPE和ΔS之间的差异计算受试者工作曲线下面积（AUC）和比值比。使用具有广义估计方程（GEE）的逻辑回归模型估计加重风险。在稳定状态下，使用两个版本软件测量的LCI 2.5%中位数存在统计学显著差异，但在PE期间没有。使用更新后的Spiroware软件，LCI连续两次就诊之间变化的AUC没有显著变化。尽管中位数较低，但使用重新计算的LCI值并不影响该参数在囊性纤维化PE中的诊断准确性。
