在解释螺旋计时使用支气管扩展后或前的参考值的后果
Andrei Malinovschi1, Xingwu Zhou1,2,3, Anders Andersson4,5
1Department of Medical Sciences, Clinical Physiology.
概括
使用支气管扩展器后参考值进行螺旋测量显著增加了空气流阻塞的检测,揭示了一般人群的呼吸负担更高. 这种方法可能有助于识别具有较轻度慢性阻塞性肺病症状的个体.
科学领域:
- 肺部医学 肺部医学
- 呼吸系统生理学 呼吸系统生理学
- 流行病学 流行病学
背景情况:
- 支气管扩展后的螺旋测量是诊断慢性阻塞性肺病 (COPD) 的标准.
- 目前的解释经常使用支气管前扩展剂的参考值,可能低估了阻塞患病率.
- 该SCAPIS研究提供了一个独特的数据集来调查这种差异.
研究的目的:
- 为了比较螺旋计的患病率,使用前与后支气管扩展剂的参考值.
- 评估使用不同参考值对识别呼吸负担的临床影响.
- 在一般人群中评估经支气管扩展器后螺旋计的解释.
主要方法:
- 利用了SCAPIS研究中的参考值 (10,156名健康非吸烟者接受支气管扩张后治疗,1,498人接受支气管扩张前治疗).
- 分析了SCAPIS一般人群中28851名个体的螺旋计数据.
- 将FEV1/FVC比率与前 bronchodilator和后 bronchodilator正常的下限 (LLN) 进行比较.
主要成果:
- 支气管扩张使FEV1/FVC的预测中位数变高,LLN变低.
- 空气流阻塞的患病率 (支气管扩张后FEV1/FVC<支气管扩张后LLN) 为9.9%.
- 另外5.1%的使用前支气管扩展剂LLNs的患者表现出增加的呼吸系统症状,肺气和自我报告的COPD.
结论:
- 支气管扩展前和后FEV1/FVC的螺旋计参考值存在显著差异.
- 使用支气管扩展后的参考值,检测到的气流阻塞患病率翻了一番.
- 这种方法可以提高轻度COPD的早期识别,并提高临床相关性.
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