肺功能测试在评估部署退伍军人的长度结果时的临床实用性 用保存的螺旋计测量
Siyang Zeng1,2, Nisha C Jani3, Anays M Sotolongo4
1University of California San Francisco, Medicine, San Francisco, California, United States.
Annals of the American Thoracic Society
|June 12, 2025
概括
许多部署的退伍军人经历呼吸系统症状,尽管正常的肺功能测试 (PFTs). 这些退伍军人的扩散能力降低 (DLCO) 预示着未来的肺部疾病,突出显示需要更密切的监测.
科学领域:
- 环境健康 环境健康
- 肺部医学 肺部医学
- 军人卫生保健 军人卫生保健
背景情况:
- 军事部署到西南亚与新出现的呼吸道症状有关.
- 肺功能测试 (PFTs) 在受影响的退伍军人中经常显示正常结果,称为部署暴露的退伍军人与保存的螺旋计 (DEPS).
- 与DEPS中正常范围的PFT参数相关的长期结果仍未得到充分研究.
研究的目的:
- 在DEPS中评估PFT参数的临床实用性.
- 检查PFT与呼吸系统症状,功能限制,医疗保健利用和DEPS的纵向轨迹之间的关联.
- 确定部署退伍军人的不良呼吸系统结果的预测性PFT参数.
主要方法:
- 美国退伍军人事务部空中危险和开放燃烧坑登记处的退伍军人分析. 部署后的PFT.
- 关于DEPS的定义:没有基于PFTs的空气流障碍或限制.
- 应用回归和机器学习模型来评估PFT参数的预测值; 对于纵向PFT轨迹的Cox回归.
主要成果:
- 在3814名符合条件的退伍军人中,68%报告呼吸系统症状;49%被归类为DEPS.
- 在DEPS (n=1,879) 中,扩散能力 (DLCO) 是结果最强的预测因素 (ORs 0.46-0.89,P<0.05).
- 随着时间的推移,低于基线DLCO的DEPS更有可能发展出限制性肺功能障碍 (33%对19%,P=0.048).
结论:
- 大约有一半的环境暴露的部署退伍军人患有DEPS,但许多人报告了显著的呼吸系统症状和功能限制.
- 在DEPS中降低DLCO与许多结果有关,并预测肺瘤疾病的发展.
- 在DEPS中,DLCO可以作为监测肺部健康的关键指标.
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