Trepić Nina, Nemet Marko, Vukoja Marija
Internal Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, SRB.
Pulmonology, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, SRB.
Cureus. 2024 Aug 14;16(8):e66844. doi: 10.7759/cureus.66844. eCollection 2024 Aug.
Introduction The European Respiratory Society/American Thoracic Society (ERS/ATS) Task Force released new technical standards on spirometry interpretation in 2021. Our study compares bronchodilator responsiveness (BDR) in asthma, evaluating the impact of the 2005 and 2021 ERS/ATS criteria and the influence of predictive equations. Methods A retrospective cohort study of adult patients with asthma was referred to spirometry with a BDR test at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. The study included adult patients with asthma who underwent BDR testing in the Department of Respiratory Pathophysiology at the institute and had available data on height, gender, age, race, and eosinophil count. Results Among 197 patients, 69 were men (35.0%), the median age was 47 years (interquartile range (IQR) 38-60), and a positive BDR test occurred in 50 (25.38%) according to the 2005 criteria and 42 (21.32%) according to 2021 criteria when using the Global Lung Initiative (GLI) reference equations. Strong agreement was observed between the ERS/ATS 2005 and 2021 criteria (Cohen's kappa index: 0.887, 95%, CI 0.810 to 0.963). Similar results were found with the Third National Health and Nutrition Examination Survey (NHANES III) and the European Community of Coal and Steel (ECCS) predictive equations. Positive BDR tests were common in patients with moderately severe and severe forced expiratory volume in one second (FEV1) impairment and were not associated with eosinophil count or total serum immunoglobulin E (IgE) levels. Conclusion The introduction of the 2021 ERS/ATS criteria did not significantly alter the classification of BDR in the majority of asthma patients, ensuring diagnostic stability. Whichever criterion was used, positive BDR correlated with the extent of FEV1 impairment, but not asthma biomarkers.
引言 欧洲呼吸学会/美国胸科学会（ERS/ATS）特别工作组于2021年发布了关于肺量计解读的新技术标准。我们的研究比较了哮喘患者的支气管扩张剂反应性（BDR），评估了2005年和2021年ERS/ATS标准的影响以及预测方程的影响。方法 对塞尔维亚斯雷姆斯卡卡梅尼察伏伊伏丁那肺病研究所进行肺量计检查并进行BDR测试的成年哮喘患者进行回顾性队列研究。该研究纳入了在该研究所呼吸病理生理学部门接受BDR测试且有身高、性别、年龄、种族和嗜酸性粒细胞计数可用数据的成年哮喘患者。结果 在197例患者中，男性69例（35.0%），中位年龄为47岁（四分位间距（IQR）38 - 60），根据2005年标准，50例（25.38%）BDR测试呈阳性，根据2021年标准，使用全球肺倡议（GLI）参考方程时为42例（21.32%）。ERS/ATS 2005年和2021年标准之间观察到高度一致性（科恩kappa指数：0.887，95%，CI 0.810至0.963）。使用第三次全国健康和营养检查调查（NHANES III）和欧洲煤钢共同体（ECCS）预测方程也发现了类似结果。BDR测试阳性在中度至重度一秒用力呼气容积（FEV1）受损患者中很常见，且与嗜酸性粒细胞计数或总血清免疫球蛋白E（IgE）水平无关。结论 2021年ERS/ATS标准的引入在大多数哮喘患者中并未显著改变BDR的分类，确保了诊断稳定性。无论使用哪种标准，BDR阳性都与FEV1受损程度相关，但与哮喘生物标志物无关。
