Greig Robert, Suter Philipp, Chan Rory, Lipworth Brian
Scottish Centre for Respiratory Research, University of Dundee, Scotland.
Scottish Centre for Respiratory Research, University of Dundee, Scotland.
Respir Med. 2025 Oct;247:108315. doi: 10.1016/j.rmed.2025.108315. Epub 2025 Aug 20.
Impulse oscillometry (IOS) - a physiological effort independent technique - is used to evaluate small airways dysfunction in asthma. The absolute values produced from IOS can be challenging to understand thus, we previously proposed using oscillometry derived ratios to aid interpretation. Patients with abnormal baseline R5-R20/R5 ratio were identified and analysed if there was a significant response in their ratios pre and post treatment on dupilumab. There were significant improvements in both R5-R20/R5 and X5/AX as well as the spirometry derived ratios FEV/FVC and FEF/FVC. The type 2 biomarkers (eosinophils and FeNO) and asthma control score also showed significant improvements, although they were not significantly correlated with the oscillometry ratios. Standardised response means showed good sensitivity for both oscillometry derived ratios and spirometry derived ratios in detecting response to treatment. Based on these observations, oscillometry derived ratios may be a viable and easier to interpret alternative to using absolute values for the evaluation of small airways response to biologic therapy in a real-life clinic setting.
脉冲振荡法（IOS）——一种独立于生理努力的技术——用于评估哮喘中的小气道功能障碍。IOS产生的绝对值可能难以理解，因此，我们之前建议使用振荡法得出的比率来辅助解读。如果接受度普利尤单抗治疗前后患者的比率有显著变化，则对基线R5-R20/R5比率异常的患者进行识别和分析。R5-R20/R5和X5/AX以及肺量计得出的比率FEV/FVC和FEF/FVC均有显著改善。2型生物标志物（嗜酸性粒细胞和呼出气一氧化氮）以及哮喘控制评分也有显著改善，尽管它们与振荡法比率无显著相关性。标准化反应均值显示，振荡法得出的比率和肺量计得出的比率在检测治疗反应方面均具有良好的敏感性。基于这些观察结果，在实际临床环境中，振荡法得出的比率可能是一种可行且更易于解读的替代方法，可用于评估小气道对生物治疗的反应，而无需使用绝对值。
