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在慢性阻塞性肺病中脉冲振荡计的诊断价值:一个多中心,回顾性,观察性研究
Lijuan Gao1, Hao Wang1, Yanqiu Wu1
1Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
BMJ open
|October 9, 2024
概括
脉冲振荡计 (IOS) 在慢性阻塞性肺病 (COPD) 患者中显示出与螺旋计的良好相关性. 然而,IOS在诊断COPD时并没有完全取代螺旋计,特别是在早期和晚期.
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
- 诊断成像 诊断成像 诊断成像
背景情况:
- 慢性阻塞性肺病 (COPD) 的诊断依赖于螺旋测量,这是一个自愿的测试.
- 脉冲振荡计 (IOS) 提供了一个非自愿的替代方案,但其在COPD的临床实用性尚未完全确定.
研究的目的:
- 评估脉冲振荡计 (IOS) 在诊断和评估慢性阻塞性肺病 (COPD) 严重程度方面的临床价值.
- 在一大批中国成年人中,比较IOS参数与螺旋计的性能.
主要方法:
- 对6307名40岁以上的参与者 (2109名COPD,4198名非COPD) 进行了回顾性观察研究.
- 收集的数据包括中国五家公立医院 (2014-2015年) 的人口统计,螺旋测量和IOS结果.
- 统计分析包括斯皮尔曼的相关性和接收机运行特征 (ROC) 曲线分析.
主要成果:
- 与非COPD患者 (p<0.0001) 相比,COPD患者在多个IOS参数 (Z5,R5,R20,R5-R20,Fres,Rp,X5) 中表现出显著差异.
- IOS参数与螺旋计指数 (MMEF25%-75%,FEV1/FVC,FEV1%) 相对应轻度至中度.
- 结合的IOS参数显示在诊断COPD (AUC 0.78) 和病期严重程度 (AUC 0.71-0.75) 中的表现不佳.
结论:
- 脉冲振荡计 (IOS) 在COPD患者中显示出与螺旋计的良好相关性.
- 在COPD诊断和严重程度评估方面,IOS不能完全取代螺旋计,尤其是在轻度或重度病例中.
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