肺功能和运动能力的变化是IPF患者接受抗纤维素治疗的死亡率的强有力的预测因素
Ju Hyun Oh1, Moo Suk Park2, Man Pyo Chung3
1Department of Pulmonary and Critical Care Medicine, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Republic of Korea.
Frontiers in medicine
|October 23, 2025
概括
在抗纤维素治疗期间监测肺功能变化在异形性肺纤维化 (IPF) 中提供了更好的预后价值. 强迫生命能力 (FVC) 和扩散能力 (DLco) 的下降预测了IPF患者的死亡风险.
科学领域:
- 肺部病理学 肺部病理学
- 纤维化间歇性肺病 纤维化间歇性肺病
- 临床预后 临床预后
背景情况:
- 异形性肺纤维化 (IPF) 是一种慢性,渐进的肺病,预后不佳.
- 抗纤维菌疗法是IPF的主要治疗方法,但预测患者的结果仍然具有挑战性.
研究的目的:
- 评估IPF患者在抗纤维素治疗期间监测肺功能和运动能力变化的预后价值.
- 为了比较纵向变化的预测准确度与死亡风险的基线参数.
主要方法:
- 来自韩国IPF队列登记处的1,229名IPF患者的回顾性分析 (2016年6月 - 2021年8月).
- 使用考克斯比例危险模型和接收器运行特征 (ROC) 曲线分析评估死亡率的预后因素.
- 评估基线参数和强迫生命能力 (FVC),一氧化碳扩散能力 (DLco) 和6分钟步行距离 (6MWD) 的变化.
主要成果:
- 在41个月的中位数随访期间,接受抗纤维素治疗的患者中有37.9%死亡.
- 死亡的独立风险因素包括12个月后FVC的下降,较低的基线DLco,12个月后DLco的下降,6个月后减少6MWD.
- 12个月后FVC的变化显示出死亡率的最高预测准确度 (AUC=0.676). 在12个月内,FVC下降≥5.8%或DLco下降≥11.5%的患者的生存率显著降低.
结论:
- 肺功能和运动能力的纵向变化是IPF抗纤维治疗反应的有价值指标.
- 这些动态变化可以作为预测IPF患者死亡风险的潜在代孕标记.
- 通过连续肺功能测试来监测治疗反应可以提高IPF管理中的预后评估.
相关概念视频
01:25Pulmonary Function Tests
729
Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
729
01:26COPD: Management Using Bronchodilators and Corticosteroids
722
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
722
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
3.1K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
3.1K
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
3.6K
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
3.6K
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
3.5K
Understanding the variety of primary symptoms and systemic complications that characterize chronic obstructive pulmonary disease (COPD) is crucial for healthcare professionals.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
3.5K
01:19Factors Affecting Pulmonary Ventilation
2.8K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
2.8K