肺功能轨迹使用种族特定与种族中立的全球肺功能倡议系数
Darshali A Vyas1, Sophia Zhao1, Peggy S Lai1
1Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston.
JAMA network open
|April 25, 2025
概括
种族中立的全球肺功能倡议 (GLI) 全球方程可能会改善黑人患者的肺功能评估. 这种方法可能比种族调整的方程更准确地识别肺病理.
科学领域:
- 肺部医学 肺部医学
- 呼吸系统健康 呼吸系统健康
- 临床诊断 临床诊断 临床诊断
背景情况:
- 肺功能测试 (PFT) 的基于种族的系数一直是标准的.
- 全球肺功能倡议 (GLI) 开发了一种种族中立的参考方程 (GLI Global),以解决对种族调整系数的担忧 (GLI 2012).
- 使用GLI Global与GLI 2012的临床影响尚未完全描述.
研究的目的:
- 为了比较GLI 2012和GLI全球参考方程对肺功能分类和轨迹的影响.
- 评估种族中立的螺旋测量解释如何影响肺功能异常的识别.
主要方法:
- 一项回顾性队列研究分析了马萨诸塞州综合医院 (1997-2020) 的24,662名患者 (18-95岁) 的螺旋计数据.
- 肺功能指标 (FEV1,FVC) 用GLI 2012和GLI全球方程进行评估.
- 患者根据z分数进行分类:正常到正常,异常到正常,正常到异常,异常到异常.
主要成果:
- 在黑人患者中,19.2%的患者使用GLI Global从正常重新归类为异常. 他们的FEV1下降与被两方程分类为异常的人相似.
- 在白人患者中,15.0%的患者使用GLI Global从异常重新归类为正常. 他们的FEV1下降与正常螺旋测量的人相似,无论方程如何.
- 在两个种族群体中,FVC轨迹模式在重新分类的参与者中不一致地变化.
结论:
- 全球GLI方程可以通过将一些从正常归类为异常来更准确地识别黑人患者的肺病理.
- 这些发现表明,一种种族中立的精神测量解释方法可以增强临床评估.
- 需要进一步的研究,以了解重新分类患者的FVC轨迹模式.
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