Papapostolou Georgia, Nasr Abir, Jarenbäck Linnea, Romberg Kerstin, Tunsäter Alf, Ankerst Jaro, Bjermer Leif, Tufvesson Ellen
Department of Clinical Sciences, Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden.
Health Care Centre, Näsets Läkargrupp, Höllviken, Sweden.
J Asthma Allergy. 2025 Apr 5;18:491-505. doi: 10.2147/JAA.S497218. eCollection 2025.
Forced Oscillation Technique (FOT) is increasingly used to measure obstruction in the airways; however, the association between airway obstruction and the actual symptom burden in asthma is not known. Therefore, we aimed to investigate central and peripheral airway obstruction, measured by FOT, in association to symptoms and quality of life in asthma.
319 asthma patients were recruited and answered questionnaires focusing on symptoms (ACT, ACQ, Nijmegen, HADS and SNOT-22) and quality of life (MiniAQLQ and MiniRQLQ) and performed FOT measurements estimating airway resistance (R5: total resistance, R19: central resistance, R5-R19: peripheral resistance) and reactance (X5) during inspiration and expiration.
Asthma groups classified based on ACT score cut-off points at 16, 20, and 25 showed higher R5, R5-R19, and lower X5 with increasing symptoms, which was not evident when applying a cut-off of only 20. ACQ-5 cut-offs at 0.75 and 1.5 captured differences in R5 and X5, whereas a Nijmegen cut-off of 23 showed differences in R5 and R19. The total scores from most questionnaires (except for the HADS and SNOT-22) correlated with many of the FOT results, but there were different patterns of correlation between airway obstruction and symptoms in uncontrolled and controlled asthma. Additionally, specific questions were associated with airway obstruction.
The increasing symptoms in patients with asthma assessed using questionnaires correlated well with predominantly increasing peripheral airway obstruction. A correlation also exists with the Nijmegen score, which is not specific to asthma. The cut-off points used to define asthma control may capture peripheral airway dysfunction.
强迫振荡技术（FOT）越来越多地用于测量气道阻塞；然而，气道阻塞与哮喘实际症状负担之间的关联尚不清楚。因此，我们旨在研究通过FOT测量的中央和外周气道阻塞与哮喘症状和生活质量之间的关系。
招募了319名哮喘患者，他们回答了关注症状（哮喘控制测试[ACT]、哮喘控制问卷[ACQ]、奈梅亨问卷、医院焦虑抑郁量表[HADS]和鼻窦鼻症状测试-22[SNOT-22]）和生活质量（迷你哮喘生活质量问卷[MiniAQLQ]和迷你呼吸相关生活质量问卷[MiniRQLQ]）的问卷，并进行了FOT测量，以估计吸气和呼气期间的气道阻力（R5：总阻力，R19：中央阻力，R5-R19：外周阻力）和电抗（X5）。
根据ACT评分切点16、20和25分类的哮喘组随着症状加重显示出更高的R5、R5-R19和更低的X5，而仅应用切点20时并不明显。ACQ-5切点0.75和1.5捕捉到了R5和X5的差异，而奈梅亨切点23显示出R5和R19的差异。大多数问卷的总分（除了HADS和SNOT-22）与许多FOT结果相关，但在未控制和控制的哮喘中，气道阻塞与症状之间存在不同的相关模式。此外，特定问题与气道阻塞相关。
使用问卷评估的哮喘患者症状加重与主要是外周气道阻塞增加密切相关。与并非哮喘特异性的奈梅亨评分也存在相关性。用于定义哮喘控制的切点可能捕捉到外周气道功能障碍。
