支气管扩展器反应的流行:旧与新标准的比较
Solanus de la Serna1, Becky Skinner2, Andrei Schwartz2
1Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Respiratory care
|July 23, 2024
概括
2021年欧洲呼吸学会/美国胸腔学会对支气管扩展剂反应的定义与2005年的指南相比,其患病率显著增加. 这种变化可能导致正常螺旋测量个体的过度诊断,这需要进一步的临床结果相关性研究.
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
背景情况:
- 2021年欧洲呼吸学会 (ERS) /美国胸腔学会 (ATS) 准则引入了对支气管扩展剂反应的新定义.
- 这个定义指定了FEV1或FVC在预测值的≥10%上升.
- 这一修订后的定义对支气管扩展剂响应率的影响仍未得到充分研究.
研究的目的:
- 用2005年和2021年ERS/ATS定义来比较支气管扩展剂反应的流行率.
- 评估新定义对不同呼吸道诊断类别的影响.
- 在正常的支气管扩展前螺旋测试对象中评估支气管扩展剂反应.
主要方法:
- 从2,696名受试者 (1997-2018) 的肺功能测试数据的回顾性分析.
- 使用2005年 (FEV1/FVC增加≥12%起始值和≥200毫升) 和2021年 (FEV1/FVC增加≥12%起始值和≥200毫升) ERS/ATS定义的支气管扩展剂反应患病率的比较.
- 统计分析包括麦克纳马测试用于流行率比较和卡帕系数用于一致性.
主要成果:
- 支气管扩展剂反应的总体患病率从9% (2005年定义) 增加到16% (2021年定义).
- 在所有呼吸道诊断类别中,患病率增加.
- 在正常的支气管扩展前螺旋测量患者中,患病率从3% (2005年) 增加到8% (2021年),特别是FEV1Z评分≥0.0的患者中,患病率从2%增加到7%.
结论:
- 与2005年定义相比,2021年ERS/ATS定义导致支气管扩展剂反应的流行率更高.
- 这种增加在正常的支气管扩展前螺旋测量患者中是显着的,特别是那些FEV1Z评分≥0的人,引发了对潜在过度诊断的担忧.
- 需要进行进一步的研究,以将支气管扩展剂反应与这一特定患者群体的临床结果相关联.
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