手握力与稳定期慢性阻塞性肺疾病患者小气道疾病的相关性。
Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease.
机构信息
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Klongluang, Pathumthani, Thailand.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, 99/209 Paholyotin Road, Klong Luang, Pathum Thani 12120, Thailand.
出版信息
Ther Adv Respir Dis. 2024 Jan-Dec;18:17534666241281675. doi: 10.1177/17534666241281675.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is associated with airflow limitation resulting from a combination of small airway disease (SAD) and parenchymal destruction. Although various diagnostic methods for SAD exist, access to these tools can be limited.
OBJECTIVES
This study aimed to explore the correlation between handgrip strength (HGS) and SAD in COPD patients.
DESIGN
Cross-sectional prospective study.
METHODS
HGS was measured using a hand dynamometer. SAD was evaluated using impulse oscillometry, with results reported as the difference between respiratory resistance at 5 and 20 Hz (R5-R20). SAD was defined as R5-R20 ⩾0.07 kPa/L/s. The receiver operator characteristic (ROC) curves, sensitivity, and specificity values were calculated to determine the optimal cutoff value of HGS for predicting SAD.
RESULTS
Sixty-four patients (90.6% male) were included. The average age was 72.1 ± 8.3 years, and body mass index was 23.4 ± 4.2 kg/m. FEV was 71.6 ± 21.3%, and HGS was 30.2 ± 8.1 kg. R5-R20 was 0.11 ± 0.08 kPa/L/s. SAD was found in 64.1% of patients. A negative correlation between HGS and R5-R20 was observed ( = -0.332, = 0.007). The best cutoff value for HGS in detecting SAD was determined to be 28.25 kg, with a sensitivity of 73.9%, specificity of 65.9%, and an area under ROC curve of 0.685 (95% CI 0.550-0.819, = 0.015).
CONCLUSION
SAD is common in COPD patients, and HGS is significantly negatively correlated with SAD. This tool might serve as an alternative or adjunctive assessment for small airway dysfunction in COPD patients.
REGISTRATION
This study was registered with ClinicalTrials.gov with number NCT06223139.
背景
慢性阻塞性肺疾病（COPD）与气流受限有关，这种气流受限是由小气道疾病（SAD）和实质破坏共同导致的。虽然存在多种用于 SAD 的诊断方法，但这些工具的应用可能会受到限制。
目的
本研究旨在探讨 COPD 患者的握力（HGS）与 SAD 之间的相关性。
设计
横断面前瞻性研究。
方法
使用手持测力计测量 HGS。使用脉冲震荡法评估 SAD，结果以呼吸阻力在 5Hz 和 20Hz 之间的差异（R5-R20）表示。SAD 定义为 R5-R20 ⩾0.07kPa/L/s。计算受试者工作特征（ROC）曲线、敏感度和特异度值，以确定 HGS 预测 SAD 的最佳截断值。
结果
共纳入 64 例患者（90.6%为男性），平均年龄为 72.1 ± 8.3 岁，体重指数为 23.4 ± 4.2kg/m。FEV 为 71.6 ± 21.3%，HGS 为 30.2 ± 8.1kg。R5-R20 为 0.11 ± 0.08kPa/L/s。64.1%的患者存在 SAD。HGS 与 R5-R20 呈负相关（ = -0.332， = 0.007）。HGS 检测 SAD 的最佳截断值为 28.25kg，敏感度为 73.9%，特异度为 65.9%，ROC 曲线下面积为 0.685（95%CI 0.550-0.819， = 0.015）。
结论
SAD 在 COPD 患者中较为常见，HGS 与 SAD 显著负相关。该工具可能成为 COPD 患者小气道功能障碍的替代或辅助评估手段。
注册
本研究已在 ClinicalTrials.gov 注册，编号为 NCT06223139。
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