Evaluation of disease severity in bronchiectasis using impulse oscillometry
Evaluation of disease severity in bronchiectasis using impulse oscillometry
复制标题
DOI：
10.1183/23120541.00053-2020
复制
发表时间：
2020-10-01
影响因子：
4.6
通讯作者：
Kida, Hiroshi
中科院分区：
文献类型：
--
作者：
Yamamoto, Yuji;Miki, Keisuke;Kida, Hiroshi
尽管脉冲振荡法(IOS)对健康受试者支扩的鉴别诊断价值已有研究，但各IOS参数预测支扩疾病严重程度的有效性尚未得到深入研究。此外，IOS在非结核分枝杆菌(NTM)感染患者中的有效性尚未见报道。本研究旨在确定呼吸阻抗的预测意义，并检测其他最重要的IOS参数，以预测支扩患者的病情严重程度，并验证IOS在NTM感染患者中的有效性。所有患者均行胸部高分辨率CT、肺活量测定和IOS检查。计算入院人数、死亡率和支气管扩张症严重程度指数(BSI、Face和E-Face评分)以评估疾病严重程度。将患者分为有和无NTM感染的亚组，并进行亚组分析。呼吸电抗，特别是共振频率(f(Res))与BSI和Face评分的相关性好于呼吸阻力。吸气阻抗与BSI、Face和E-Face得分密切相关，而呼气阻抗与BSI、Face和E-Face得分无明显相关性。吸气f(Res)是最有用的预测指标，随着病情的加重而增加。在有和没有NTM感染的患者中，IOS的有效性几乎是相同的。通过IOS测量的呼吸电抗有助于评估支气管扩张的疾病严重程度。吸气f(Res)最能预测有无NTM感染的支扩患者的病情严重程度。
Although the diagnostic value of impulse oscillometry (IOS) in bronchiectasis for the differential diagnosis of healthy subjects has been researched, the usefulness of each IOS parameter for predicting disease severity in bronchiectasis has not been thoroughly investigated. In addition, the usefulness of IOS in patients with nontuberculous mycobacteria (NTM) infection has not been reported. This study aimed to determine the predictive significance of respiratory impedance and detect the other most significant IOS parameters for predicting disease severity in bronchiectasis patients and to validate the usefulness of IOS in patients with NTM infection.A total of 206 patients with bronchiectasis who attended clinics at the National Hospital Organization Osaka Toneyama Medical Center were included. Chest high-resolution computed tomography, spirometry and IOS were performed. Hospital admissions, mortality and disease severity indices for bronchiectasis (Bronchiectasis Severity Index (BSI), FACED, and E-FACED scores) were calculated to assess disease severity. The patients were divided into subgroups with and without NTM infection, and subgroup analyses were performed.Respiratory reactance, especially resonant frequency (f(res)), correlated with both BSI and FACED score better than respiratory resistance. Inspiratory but not expiratory impedance was strongly correlated with BSI, FACED and E-FACED scores. Inspiratory f(res) was the most useful predictor, increasing as the disease became more severe. The usefulness of IOS was almost equivalent in patients both with and without NTM infection.Inspiratory reactance measured by IOS is useful for estimating disease severity in bronchiectasis. Inspiratory f(res) best predicts disease severity in bronchiectasis patients both with and without NTM infection.