Teixeira Elayne Moura, Ribeiro Caroline Oliveira, Lopes Agnaldo José, de Melo Pedro Lopes
Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Pulmonary Function Laboratory, Pedro Ernesto University Hospital, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Int J Chron Obstruct Pulmon Dis. 2024 Mar 6;19:667-682. doi: 10.2147/COPD.S446085. eCollection 2024.
Chronic obstructive pulmonary disease (COPD) phenotypes may introduce different characteristics that need to be known to improve treatment. Respiratory oscillometry provides a detailed analysis and may offer insight into the pathophysiology of COPD. In this paper, we used this method to evaluate the differences in respiratory mechanics of COPD phenotypes.
This study investigated a sample of 83 volunteers, being divided into control group (CG = 20), emphysema (n = 23), CB (n = 20) and asthma-COPD overlap syndrome (ACOS, n = 20). These analyses were performed before and after bronchodilator (BD) use. Functional capacity was evaluated using the Glittre‑ADL test, handgrip strength and respiratory pressures.
Initially it was observed that oscillometry provided a detailed description of the COPD phenotypes, which was consistent with the involved pathophysiology. A correlation between oscillometry and functional capacity was observed (r=-0.541; p = 0.0001), particularly in the emphysema phenotype (r = -0.496, p = 0.031). BD response was different among the studied phenotypes. This resulted in an accurate discrimination of ACOS from CB [area under the receiver operating curve (AUC) = 0.84] and emphysema (AUC = 0.82).
These results offer evidence that oscillatory indices may enhance the comprehension and identification of COPD phenotypes, thereby potentially improving the support provided to these patients.
慢性阻塞性肺疾病(COPD)的表型可能具有不同特征,了解这些特征有助于改善治疗。呼吸振荡法可提供详细分析,并可能有助于深入了解COPD的病理生理学。在本文中,我们使用该方法评估COPD表型的呼吸力学差异。
本研究调查了83名志愿者,分为对照组(CG = 20)、肺气肿组(n = 23)、慢性支气管炎组(CB,n = 20)和哮喘-COPD重叠综合征组(ACOS,n = 20)。这些分析在使用支气管扩张剂(BD)前后进行。使用Glittre-ADL测试、握力和呼吸压力评估功能能力。
最初观察到,振荡法能够详细描述COPD表型,这与所涉及的病理生理学一致。观察到振荡法与功能能力之间存在相关性(r = -0.541;p = 0.0001),尤其是在肺气肿表型中(r = -0.496,p = 0.031)。在所研究的表型中,BD反应有所不同。这使得能够准确区分ACOS与CB [受试者操作特征曲线下面积(AUC)= 0.84]以及肺气肿(AUC = 0.82)。
这些结果表明,振荡指数可能有助于增强对COPD表型的理解和识别,从而有可能改善为这些患者提供的支持。