Ziegahn Niklas, Roehmel Jobst F, Pioch Charlotte O, Busack Leonie M, Allomba Christine, Fuhlrott Bent R, Meinus Carolin, Schnabel Olaf, Yoosefi Moridani Mehrak, Thee Stephanie, Lau Susanne, Mall Marcus A, Stahl Mirjam
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
N. Ziegahn and J.F. Roehmel contributed equally as first authors.
ERJ Open Res. 2025 Jun 23;11(3). doi: 10.1183/23120541.00987-2024. eCollection 2025 May.
Multiple-breath washout (MBW) is an established outcome measure of lung disease in cystic fibrosis (CF). However, data on its sensitivity to detect lung function impairment in bronchiectasis across age groups remain limited. The aim of this study was therefore to determine the feasibility, validity and sensitivity of MBW compared with spirometry in people with bronchiectasis.
We performed MBW and spirometry in 94 people with bronchiectasis (aged 0.2 to 79.3 years), 168 healthy controls, and 128 people with CF and 76 with asthma as disease controls.
The overall success rate of MBW in all 466 participants was 96.1%. People with bronchiectasis had an elevated lung clearance index (LCI) and a reduced forced expiratory volume in 1 s (FEV) compared with healthy controls and people with asthma (all p<0.001). Comparing bronchiectasis and CF, there was no difference in LCI, but FEV was reduced in bronchiectasis (p=0.032). Within the bronchiectasis group, LCI correlated strongly with FEV (r= -0.69, p<0.001). However, 34.3% of people with bronchiectasis presented with an elevated LCI but normal FEV, while none had a reduced FEV combined with a normal LCI (p<0.001). LCI was superior to FEV in detecting lung function impairment in bronchiectasis (area under the curve: 0.95 0.86).
LCI is more sensitive than FEV to detect lung function impairment in bronchiectasis. These findings support further evaluation of LCI for clinical monitoring and as a sensitive outcome measure in clinical trials in people with bronchiectasis.
多次呼吸洗脱（MBW）是囊性纤维化（CF）肺病的既定结局指标。然而，关于其在各年龄组支气管扩张症中检测肺功能损害的敏感性的数据仍然有限。因此，本研究的目的是确定MBW与肺量计相比在支气管扩张症患者中的可行性、有效性和敏感性。
我们对94例支气管扩张症患者（年龄0.2至79.3岁）、168例健康对照者、128例CF患者和76例哮喘患者作为疾病对照者进行了MBW和肺量计检查。
所有466名参与者中MBW的总体成功率为96.1%。与健康对照者和哮喘患者相比，支气管扩张症患者的肺清除指数（LCI）升高，1秒用力呼气量（FEV）降低（均p<0.001）。比较支气管扩张症和CF，LCI无差异，但支气管扩张症患者的FEV降低（p=0.032）。在支气管扩张症组中，LCI与FEV密切相关（r=-0.69，p<0.001）。然而，34.3%的支气管扩张症患者LCI升高但FEV正常，而无一例FEV降低同时LCI正常（p<0.001）。在检测支气管扩张症患者的肺功能损害方面，LCI优于FEV（曲线下面积：0.95对0.86）。
在检测支气管扩张症患者的肺功能损害方面，LCI比FEV更敏感。这些发现支持进一步评估LCI用于临床监测以及作为支气管扩张症患者临床试验中的敏感结局指标。
