参考方程对肺功能的影响以及纤维化间歇性肺病的结果
Veronica Marcoux1, Prosanta Mondal2, Ayodeji Adegunsoye3
1Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
ERJ open research
|December 10, 2025
概括
不同的肺功能参考方程影响纤维化间歇性肺病 (ILD) 的严重程度分类和进展. 虽然预后意义通常相似,但2023年GLIFVC方程显示非白人患者的差异.
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
- 间歇性肺部疾病研究研究
背景情况:
- 不同的肺功能参考方程和解释方法对纤维化间歇性肺病 (ILD) 的影响尚不清楚.
- 准确评估疾病严重程度,进展和预后对于管理纤维性ILD至关重要.
- 现有的注册表数据可能与标准化全球肺功能倡议 (GLI) 参考值不一致.
研究的目的:
- 评估全球肺功能倡议 (GLI) 的不同参考方程如何影响纤维性ILD的疾病严重程度分类.
- 评估强迫生命能力 (FVC) 和肺部对一氧化碳 (DLCO) 测量扩散能力对纵向轨迹的影响和预后意义.
- 在纤维性ILD患者中,将GLI衍生的百分比预测和z-score与注册记录的肺功能值进行比较.
主要方法:
- 利用了来自三个潜在注册表的5026名患者的连续肺功能数据.
- 使用2012/2023 GLI FVC和2017 GLI DLCO参考方程计算了预测的百分比和z-score.
- 与基线和纵向评估,严重程度分类,进展,无移植存活率和ILD-性别-年龄-生理学模型性能记录的注册表记录的数据比较GLI衍生值.
主要成果:
- 与注册表数据相比,GLI参考方程式的基线FVC和DLCO百分比预测值始终较高.
- 肺功能严重程度分类显示,对预测的百分比值有很好的一致性 (FVC的κ 0.69-0.76,DLCO的0.70),但对z-score只有中度的一致性 (FVC 0.41-0.50,DLCO0.45).
- 2023年GLI FVC和2017年GLI DLCO方程显示了最大的1年下降;较低的基线值 (GLI和注册) 与较差的无移植生存相关,风险分层表现相似,除了非白人患者的2023年GLI FVC.
结论:
- 选择肺功能参考方程和解释方法显著影响疾病严重程度的分类和纤维化ILD的纵向轨迹评估.
- 预后意义在各方法中仍然很相似,但2023年GLI FVC方程在非白人人口中显示出差异关联.
- 需要仔细考虑参考方程,以便在纤维化ILD管理中对肺功能进行一致和准确的解释.
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