Toumpanakis Dimitrios, Karagiannis Konstantinos, Paredi Paolo, Bikov Andras, Bonifazi Martina, Lota Harpreet K, Kalsi Harpal, Minelli Cosetta, Dikaios Nikolaos, Kastis George A, Barnes Peter J, Wells Athol U, Usmani Omar S, Renzoni Elisabetta A
National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, United Kingdom; Second Department of Critical Care Medicine, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Interstitial Lung Disease Unit, Imperial College London and Royal Brompton Hospital, London, United Kingdom.
Chest. 2025 Aug;168(2):423-434. doi: 10.1016/j.chest.2025.02.036. Epub 2025 Mar 11.
Sarcoidosis is characterized by reduced quality of life (QoL), yet QoL is correlated poorly to conventional spirometric lung function tests.
What is the relationship of a QoL measure with comprehensive lung function assessment using oscillometry in sarcoidosis?
Sixty-two patients with pulmonary sarcoidosis completed the St. George's Respiratory Questionnaire (SGRQ), a respiratory QoL measure, and underwent lung function assessment including oscillometry, spirometry, diffusion capacity, fractional exhaled nitric oxide (Feno), and body plethysmography. Relationships of lung function parameters with SGRQ results were determined with Spearman rank coefficient (ρ), and receiver operating characteristic curves were plotted. Logistic regression and hierarchy cluster analysis of parameters from multiple lung function techniques were performed.
Oscillometric indices describing peripheral lung dysfunction showed significant associations with SGRQ score (resistance at 5 Hz [R5], ρ = 0.43 [P < .01]; R5 minus resistance at 20 Hz [R20], ρ = 0.35 [P < .01]; reactance at 5 Hz [X5], ρ = -0.42 [P < .01]; reactance area under the curve [Ax], ρ = 0.44 [P < .01]), whereas FVC % predicted and residual volume to total lung capacity ratio, were related weakly to SGRQ score (ρ = -0.30 [P = .02] and ρ = 0.30 [P = .02], respectively). Oscillometry reactance, measuring elastic properties of the lung, predicted an impaired QoL (area under the receiver operating characteristic curve: Ax, 0.80 [P < .001] and X5, 0.78 [P < .001]), even in patients with absence of an obstructive or restrictive spirometry pattern. Ax remained associated significantly with SGRQ score even after adjustment for FVC and Scadding stage on multivariable analysis (P = .005). Feno was not associated with SGRQ score. Peripheral airway function parameters (R5 minus R20, Ax, and residual volume to total lung capacity ratio) were grouped in an independent cluster, whereas X5 constituted a single cluster.
Our results indicate that oscillometric lung function parameters, especially those of peripheral airway dysfunction, are correlated more strongly to a QoL measure than spirometry in patients with sarcoidosis.
结节病的特征是生活质量（QoL）下降，然而QoL与传统的肺量计肺功能测试相关性较差。
在结节病中，QoL测量与使用振荡法进行的综合肺功能评估之间有什么关系？
62例肺结节病患者完成了圣乔治呼吸问卷（SGRQ），这是一种呼吸QoL测量方法，并接受了肺功能评估，包括振荡法、肺量计、弥散功能、呼出一氧化氮分数（Feno）和体容积描记法。用Spearman等级系数（ρ）确定肺功能参数与SGRQ结果的关系，并绘制受试者工作特征曲线。对多种肺功能技术的参数进行逻辑回归和层次聚类分析。
描述外周肺功能障碍的振荡指标与SGRQ评分显著相关（5Hz时的阻力[R5]，ρ = 0.43 [P <.01]；R5减去20Hz时的阻力[R20]，ρ = 0.35 [P <.01]；5Hz时的电抗[X5]，ρ = -0.42 [P <.01]；曲线下电抗面积[Ax]，ρ = 0.44 [P <.01]），而预计的用力肺活量百分比和残气量与肺总量之比与SGRQ评分的相关性较弱（分别为ρ = -0.30 [P =.02]和ρ = 0.30 [P =.02]）。测量肺弹性特性的振荡电抗预测QoL受损（受试者工作特征曲线下面积：Ax为0.80 [P <.001]，X5为0.78 [P <.001]），即使在没有阻塞性或限制性肺量计模式的患者中也是如此。在多变量分析中，即使在调整了用力肺活量和Scadding分期后，Ax仍与SGRQ评分显著相关（P =.005）。Feno与SGRQ评分无关。外周气道功能参数（R5减去R20、Ax和残气量与肺总量之比）被归为一个独立的聚类，而X5构成一个单独的聚类。
我们的结果表明，在结节病患者中，振荡肺功能参数，尤其是外周气道功能障碍的参数，与QoL测量的相关性比肺量计更强。
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