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Anastasiia Vasileva¹, Nour Hanafi¹, Ella Huszti²

¹Division of Respirology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Frontiers in medicine

|June 12, 2023

概括

在振荡计测量 (而不是螺旋计) 中的个体内变化与急性细胞排斥相关,并预测肺移植后慢性肺异位功能障碍风险. 这表明振荡计可以监测肺部全移植健康状况.

科学领域:

肺部病理学肺部病理学
移植免疫学移植免疫学
医疗器械技术医疗器械技术

背景情况:

慢性肺异位功能障碍 (CLAD) 是肺移植后的主要死亡原因,急性细胞排斥 (ACR) 是主要的风险因素.
螺旋测量,虽然是标准的,但在ACR发作期间经常显示稳定的FEV1,限制了其灵敏度.
振荡计提供了灵敏的呼吸机制测量,跟踪肺移植损伤和恢复.

研究的目的:

为了研究这样的假设,即在振荡计测量中的个体内变化与ACR和发展CLAD的风险相关联.
为了比较振荡计变量的预测值与用于CLAD开发的螺旋计变量的预测值.

主要方法:

一组289名双边肺接受者使用振荡计和螺旋计进行了监测.
进行了多变量和有条件的逻辑回归分析,以评估A分数 (累积ACR指数) 和振荡计/螺旋计指标差异之间的关联.
患有CLAD的患者与没有CLAD的接受者进行了时间匹配以进行分析.

主要成果:

A分数与振荡计测量的变异增加有积极的关联.
在振荡度指标 (呼吸器不均质,X5,AX,R5-19) 中较高的差异独立预测了CLAD风险增加 (p <0.05).
螺旋计预测FEV1的百分比变异与CLAD风险没有关联.

结论:

振荡计是一种敏感的工具,用于跟踪肺移植损伤和移植后的恢复.
监测振荡计变异性可能能够更早地检测移植损伤,促进及时干预.
这种方法可能会降低慢性肺异位移植功能障碍的风险.

关键词:

急性排斥 (AR) 是一种急性排斥.慢性肺异位移植功能障碍 (CLAD)肺移植 (LTx) 是一种肺移植.振荡计测量 (oscillometry) 是一种方法来测量振荡.肺功能测试 (PFT) 是指肺功能测试.

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