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探索帕金森病中的肺功能障碍:脉冲振荡法的作用——一项系统综述

Exploring Pulmonary Dysfunction in Parkinson's Disease: The Role of Impulse Oscillometry-A Systematic Review.

作者信息

Gache Alexandra-Cristiana, Danteș Elena, Mocanu Elena, Postu Andreea-Cristina, Opariuc-Dan Cristian, Axelerad Any

机构信息

Department of Pneumology, Faculty of Medicine, Campus-Corp B, Ovidius University of Constanta, 1 University Alley, 900470 Constanta, Romania.

Medical Doctoral School, Faculty of Medicine, Campus-Corp B, Ovidius University of Constanta, 1 University Alley, 900470 Constanta, Romania.

出版信息

J Clin Med. 2025 May 26;14(11):3730. doi: 10.3390/jcm14113730.

Abstract

: This systematic review aimed to synthesize current evidence on the use of impulse oscillometry (IOS) in assessing pulmonary function in patients with Parkinson's disease (PD). IOS, as an effort-independent method, may offer advantages over conventional spirometry in detecting early or subclinical respiratory impairment in neurologically compromised populations. : A systematic search was conducted across PubMed, Web of Science, Scopus, ScienceDirect and Google Scholar for observational studies published up to March 2025. The included studies involved patients diagnosed with PD who underwent respiratory assessment using IOS, either alone or in combination with spirometry. Data on IOS parameters (R5, R20, X5, AX) and their associations with disease severity, spirometric values or autonomic markers were extracted and analyzed qualitatively. : Four studies, published between 2020 and 2023, met the inclusion criteria. IOS revealed increased airway resistance in early-stage PD and inverse correlations with spirometric indices such as FEV1 and PEF. One study demonstrated significant correlations between IOS parameters and parasympathetic heart rate variable indices, suggesting autonomic involvement. IOS also showed stability across dopaminergic treatment states, highlighting its reliability in longitudinal monitoring. : IOS appears to be a promising adjunct to traditional respiratory assessment in PD, capable of identifying subtle mechanical and autonomic dysfunctions. Despite encouraging results, the current evidence remains limited and further large-scale, longitudinal studies are needed to validate its clinical utility.

摘要

本系统评价旨在综合目前关于脉冲振荡法(IOS)在评估帕金森病(PD)患者肺功能方面的证据。IOS作为一种无需用力的方法,在检测神经功能受损人群的早期或亚临床呼吸功能损害方面可能比传统肺量计具有优势。

对PubMed、科学网、Scopus、ScienceDirect和谷歌学术进行了系统搜索,以查找截至2025年3月发表的观察性研究。纳入的研究涉及被诊断为PD且接受了IOS呼吸评估的患者,评估方式可以是单独使用IOS,也可以是将其与肺量计联合使用。提取并定性分析了IOS参数(R5、R20、X5、AX)及其与疾病严重程度、肺量计值或自主神经标志物的关联数据。

2020年至2023年间发表的四项研究符合纳入标准。IOS显示早期PD患者气道阻力增加,且与FEV1和PEF等肺量计指标呈负相关。一项研究表明IOS参数与副交感神经心率变异性指标之间存在显著相关性,提示存在自主神经受累情况。IOS在多巴胺能治疗状态下也显示出稳定性,突出了其在纵向监测中的可靠性。

IOS似乎是PD传统呼吸评估的一种有前景的辅助手段,能够识别细微的机械和自主神经功能障碍。尽管结果令人鼓舞,但目前的证据仍然有限,需要进一步开展大规模的纵向研究来验证其临床实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3195/12156417/b300c20792c6/jcm-14-03730-g001.jpg

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