预测慢性气流阻塞的最佳螺旋测量值:一项跨国纵向研究
Abby H S Lam1,2, Sheikhah A Alhajri1,3,2, James Potts1
1National Heart and Lung Institute, Imperial College London, London, UK.
ERJ open research
|March 5, 2025
概括
早期发现慢性气流阻塞对于COPD至关重要. 螺旋测量,特别是支气管扩展前FEV1/FVC比率低于第9/10百分位,有效地识别了风险人群,甚至在症状出现之前.
科学领域:
- 肺部医学 肺部医学
- 呼吸系统健康 呼吸系统健康
- 流行病学 流行病学
背景情况:
- 慢性气流阻塞是慢性阻塞性肺部疾病 (COPD) 的标志.
- 目前用于早期检测慢性气流阻塞的策略有限.
- 识别患有早期气流阻塞的个体对于及时干预至关重要.
研究的目的:
- 为了确定螺旋计参数的最佳z-score值,以识别慢性气流阻塞.
- 评估螺旋计与呼吸道症状在预测气流阻塞发生率方面的疗效.
- 调查吸烟状态对发展慢性气流阻塞的风险的影响.
主要方法:
- 分析了来自跨国阻塞性肺病负担 (BOLD) 研究的数据.
- 在基线和随访 (中位数8.4年) 收集呼吸系统症状和支气管扩展前和后的螺旋计.
- 使用NHANES参考方程计算z-score,并使用Youden指数识别最佳值.
主要成果:
- 螺旋测量参数显示慢性气流阻塞发生率 (AUC 0.80-0.84),表现优于呼吸道症状.
- 在支气管扩展前FEV1/FVC的最佳z-score值被确定为<-1.336 (第9百分位),灵敏度为78%和特异性为72%.
- 观察到较低的支气管扩展后FEV1/FVC和与随访时慢性气流阻塞的几率增加相关的值.
结论:
- 螺旋计是一种比呼吸系统症状更有效的工具,用于预测慢性气流阻塞的发生率.
- 支气管扩张前FEV1/FVC比率低于第9/10百分位可能表明早期气流阻塞或COPD前.
- 目前吸烟者和,在某种程度上,低FEV1/FVC基线比率的从未吸烟者,特别是男性,面临的风险略高.
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