Kim Taehun, Kim Mi-Ae, Youn Seong Hwan, Kwon Yongshik, Kim Hyun Jung, Park Jae Seok, Park Sun Hyo
Division of Pulmonary Medicine, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 1035, Dalgubeol-daero, Dalseo-gu, Daegu, 42601, South Korea.
Sci Rep. 2025 Feb 24;15(1):6670. doi: 10.1038/s41598-025-91060-6.
Idiopathic pulmonary fibrosis (IPF) is characterised by progressive worsening of lung function. In some cases, IPF is accompanied by air-trapping and emphysema. This study aimed to evaluate air trapping quantified with RV/TLC in patients with IPF. This retrospective study included 122 patients diagnosed with IPF in South Korea between January 2011 and December 2020. Air trapping was defined as RV/TLC ≥ 0.40. Increased RV/TLC was found in 34.4% of all patients. The RV/TLC negatively correlated with lung function (forced expiratory volume in 1 s and functional vital capacity [FVC]) and showed consistent results after 1 year of follow-up. After propensity score matching, FVC and diffusion capacity between the groups showed no statistical difference. No difference in lung function decline was found between the increased and not increased RV/TLC groups. Regarding univariable analysis, the patients in the increased RV/TLC group had a lower risk of all-cause mortality (hazard ratio 1.753, P = 0.034). Using multivariable analysis, age, pirfenidone treatment, and FVC were significant factors for survival but not increased RV/TLC. Increased RV/TLC was related to emphysema and demonstrated a negative relationship with lung function. Although increased RV/TLC might relate to poor clinical outcome, it was not independent prognostic factor for IPF.
特发性肺纤维化（IPF）的特征是肺功能进行性恶化。在某些情况下，IPF伴有气体潴留和肺气肿。本研究旨在评估通过残气量/肺总量（RV/TLC）量化的IPF患者的气体潴留情况。这项回顾性研究纳入了2011年1月至2020年12月期间在韩国诊断为IPF的122例患者。气体潴留定义为RV/TLC≥0.40。在所有患者中，34.4%发现RV/TLC升高。RV/TLC与肺功能（第1秒用力呼气量和功能肺活量[FVC]）呈负相关，并且在随访1年后结果一致。倾向得分匹配后，两组之间的FVC和弥散能力无统计学差异。RV/TLC升高组和未升高组之间的肺功能下降无差异。单因素分析显示，RV/TLC升高组患者的全因死亡率风险较低（风险比1.753，P = 0.034）。多因素分析显示，年龄、吡非尼酮治疗和FVC是生存的重要因素，但RV/TLC升高不是。RV/TLC升高与肺气肿有关，并且与肺功能呈负相关。虽然RV/TLC升高可能与不良临床结局有关，但它不是IPF的独立预后因素。
