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冲动振荡计确定了正常螺旋计的喘患者的小呼吸道功能障碍:患病率,临床关联以及对控制喘的影响
Marcello Cottini1, Benedetta Bondi2, Diego Bagnasco2
1Allergy and Pneumology Outpatient Clinic, Bergamo, Italy.
Respiratory medicine
|August 18, 2023
概括
小气道功能障碍 (SAD) 在喘患者中常见,其螺旋计正常,影响喘控制,通常被标准测试遗漏. 脉冲振荡计 (IOS) 更好地检测SAD,揭示了与超重和恶化的联系.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 肺部病理学 肺部病理学
- 诊断工具 诊断工具
背景情况:
- 小气道功能障碍 (SAD) 在喘中越来越多地被认可.
- 有限的数据存在SAD在喘患者与正常的螺旋计 (NS).
- 脉冲振荡计 (IOS) 是检测SAD的一个关键方法.
研究的目的:
- 为了确定IOS定义的SAD在患有NS的喘患者中的患病率和临床特征.
- 评估IOS定义的SAD对喘控制的影响.
- 为了比较IOS定义的SAD与螺旋计定义的SAD.
主要方法:
- 纳入了321名喘患者,他们的螺旋测量正常.
- 患者根据IOS定义的SAD (R5-R20 > 0.07 kPa·s/L) 进行了分层.
- 螺旋测量定义的SAD (预测FEF25-75<65%) 也被评估. 收集和分析了临床数据.
主要成果:
- 在54.1%的患者中,IOS定义的SAD被发现,而螺旋计则为10%.
- IOS定义的SAD与较差的喘控制和较高的吸入性皮质类固醇使用有关.
- 超重,恶化史,夜间醒来和运动引起的症状与SAD有关.
结论:
- IOS定义的SAD在喘患者中普遍存在,其螺旋测量正常.
- IOS定义的SAD与更糟糕的喘控制和增加的症状负担有关.
- 标准的螺旋计可能会忽略喘中显著的小气道功能障碍.
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