Sharma Atul K, Sorte Smita R, Rathod Sachin B, Phatak Mrunal
Physiology, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.
Cureus. 2024 Dec 31;16(12):e76677. doi: 10.7759/cureus.76677. eCollection 2024 Dec.
Smoking remains a significant public health concern, associated with a myriad of diseases, including chronic obstructive pulmonary disease, cardiovascular diseases, and various cancers. While spirometry is the gold standard for assessing lung function, it may lack sensitivity in detecting early changes in respiratory mechanics induced by smoking. This study aims to evaluate the clinical potential of the forced oscillation technique (FOT) in detecting early changes in the respiratory mechanics of smokers and its correlation with computerized spirometry. This study aims to bridge this gap by investigating the utility of FOT, a noninvasive method requiring less patient cooperation, in detecting early changes in respiratory mechanics among smokers.
The study was conducted on 36 healthy nonsmokers and 36 healthy smokers. We conducted FOT and computerized spirometry, comparing these parameters between the two groups and finding correlations between FOT and spirometry parameters.
A statistically significant difference was found across different smoking indices for computerized spirometer parameters forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), marginal significance for peak expiratory flow, and no statistically significant for FEV1/FVC ratio and forced expiratory flow between 25 and 75% of vital capacity. We did not find statistically significant differences across different smoking indexes for FOT parameters, resistance at 5 Hz (R5), resistance at 20 Hz (R20), resistance difference between 5 and 20 Hz (R5-20), reactance at 5 Hz, reactance at 20 Hz (X20), area under the reactance curve (AX), resonance frequency (Fres), and resistance at resonance. However, Fres had shown marginal significance. The study revealed notable negative correlations between airway resistance parameters (such as R5 and R5-20) and the FEV1/FVC ratio, and significant negative correlations were also identified between airway reactance parameters (AX and Fres) and FEV1.
The results emphasize that FVC and FEV1 appear to be early markers of damage. The smoking index (1-70) did not significantly influence the FOT parameters in the examined population with the Quark i2m FOT machine (COSMED, Italy). Nevertheless, marginal significance in FOT Fres parameters suggests potential alterations with longer smoking durations, warranting further investigation. Also, significant negative correlations were found between the FOT and pulmonary function test parameters.
吸烟仍然是一个重大的公共卫生问题,与多种疾病相关,包括慢性阻塞性肺疾病、心血管疾病和各种癌症。虽然肺活量测定法是评估肺功能的金标准,但在检测吸烟引起的呼吸力学早期变化方面可能缺乏敏感性。本研究旨在评估强迫振荡技术(FOT)在检测吸烟者呼吸力学早期变化中的临床潜力及其与电脑化肺活量测定法的相关性。本研究旨在通过研究FOT(一种需要患者较少配合的非侵入性方法)在检测吸烟者呼吸力学早期变化中的效用,来填补这一空白。
该研究对36名健康非吸烟者和36名健康吸烟者进行。我们进行了FOT和电脑化肺活量测定,比较两组之间的这些参数,并找出FOT与肺活量测定参数之间的相关性。
在电脑化肺活量测定仪参数用力肺活量(FVC)和一秒用力呼气量(FEV1)的不同吸烟指数之间发现了统计学上的显著差异,呼气峰值流速有边缘显著性,而FEV1/FVC比值和肺活量25%至75%之间的用力呼气流量无统计学显著差异。我们未在FOT参数(5赫兹时的阻力(R5)、20赫兹时的阻力(R20)、5至20赫兹之间的阻力差(R5 - 20)、5赫兹时的电抗、20赫兹时的电抗(X20)、电抗曲线下面积(AX)、共振频率(Fres)和共振时的阻力)的不同吸烟指数之间发现统计学上的显著差异。然而,Fres显示出边缘显著性。该研究揭示了气道阻力参数(如R5和R5 - 20)与FEV1/FVC比值之间存在显著负相关,气道电抗参数(AX和Fres)与FEV1之间也存在显著负相关。
结果强调FVC和FEV1似乎是损伤的早期标志物。在使用Quark i2m FOT机器(意大利COSMED公司)检测的人群中,吸烟指数(1 - 70)对FOT参数没有显著影响。然而FOT的Fres参数的边缘显著性表明,吸烟时间较长时可能存在潜在变化,值得进一步研究。此外,还发现FOT与肺功能测试参数之间存在显著负相关。