喘息の悪化と症状を伴う新しい強制呼吸比率の実際の評価
Fraser Paterson1, Jing Yuan On1, Dania Ahmed1
1University of Dundee, School of Medicine, Dundee, UK.
まとめ
新しい肺機能測定法 (FEV3- FEV1) / FVCとFEV3/ FEV6は,中等から重度の喘息患者の喘息の悪化や症状のコントロールを予測できなかった. 従来のスピロメトリーは,喘息の重症度と悪化リスクを評価するために臨床的により価値があります.
科学分野:
- 肺医学
- 呼吸器の生理学
背景:
- 小型呼吸道機能障害 (SAD) は,常規のスピロメトリーで検出されない,持続性喘息の重要な特徴です.
- (FEV3-FEV1) /FVCとFEV3/FEV6のような新しいマーカーは,周辺の空気流の制限を捉えることを目的としています.
研究 の 目的:
- 新規のスピロメトリック比率 ((FEV3-FEV1) /FVC,FEV3/FEV6) と中等から重度の喘息の臨床結果との関連を評価する.
- これらの新しい比率の予測値と,症状制御と悪化頻度に関する伝統的な肺機能測定値を比較する.
主な方法:
- 中等から重度の喘息を患った294人の成人の臨床的,生理学的,およびバイオマーカーのデータを遡及的に分析した.
- 多変量モデルを使用して,スピロメトリック/オシロメトリックパラメータと症状制御や重症悪化などのアウトカムとの関連性を評価した.
主要な成果:
- (FEV3- FEV1) / FVCの比率も,FEV3/ FEV6の比率も,喘息の症状のコントロールや重症化率と有意に結びついていませんでした.
- 伝統的な測定法 (FEV1/FVC,FEF25- 75/FVC) とオシロメトリー (Rrs5-20) は,過去の悪化と有意な関連性を示した.
- FEV1/FVCは新しい比率と中程度に相関しているが,Rrs5~20との相関は弱かったため,生理学的評価は異なっていた.
結論:
- (FEV3-FEV1) /FVCとFEV3/FEV6の比率は,中等から重度の喘息の悪化リスクや症状制御を予測する独立した臨床的価値を提供していません.
- 従来の肺機能検査 (FEV1/FVCなど) は,この患者集団における臨床結果の評価においてより有効である.
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