A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis.
A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis.
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作者：
Busacker A;Newell JD Jr;Keefe T;Hoffman EA;Granroth JC;Castro M;Fain S;Wenzel S
严重的哮喘患者增加了生理测量的空气滞留。然而，使用CT测量空气滞留的类似研究还没有进行。这项研究旨在解决两个假设：1)通过多探测器CT定量方法测量的空气滞留将是更严重的哮喘表型的预测因子；2)历史、临床、过敏或炎症危险因素可以通过多变量分析来识别。对重症哮喘研究项目受试者的一个子集进行多探测器CT扫描，并在功能剩余容量下进行。空气滞留定义为小于或等于−850HU的肺组织的9.66%或更多。然后，使用单变量和多变量统计分析，将被定义为空气捕集器的受试者与非空气捕集器的受试者在临床和人口学因素上进行比较。空气滞留者明显更有可能有与哮喘相关的住院、ICU就诊和/或机械通气史。哮喘病程(OR 1.42，95%CI 1.08~1.87)、肺炎病史(OR 8.55，95%CI 2.07~35.26)、中性粒细胞水平高(OR 8.67，95%CI 2.05~36.57)、气流阻塞(FEV1/FVC)(OR 1.61，95%CI 1.21~2.14)和特应性疾病(OR 11.54，95%CI 1.97~67.70)是与空气滞留表型相关的独立危险因素。定量CT测定哮喘受试者的空气滞留，确定了一组有严重疾病高风险的个体。这种表型的存在有几个独立的危险因素，也许最有趣的是肺炎、中性粒细胞炎症和特应性病史。
Severe asthma subjects have increased physiologically measured air trapping. However, a similar study using CT measures of air trapping has not been performed. This study was designed to address two hypotheses: 1) air trapping, measured by multi-detector CT quantitative methodology, would be a predictor of a more severe asthma phenotype; and 2) historical, clinical, allergic, or inflammatory risk factors could be identified via multivariate analysis. Multi-detector CT scanning of a subset of the Severe Asthma Research Program subjects was performed at functional residual capacity. Air trapping was defined as 9.66% or more of the lung tissue less than −850 HU. Subjects who were defined as air trappers were then compared to non-trappers on clinical and demographic factors using both univariate and multivariate statistical analysis. Air trappers were significantly more likely to have a history of asthma-related hospitalizations, ICU visits and/or mechanical ventilation. Duration of asthma (OR 1.42, 95% CI 1.08–1.87), history of pneumonia (OR 8.55, 95% CI 2.07–35.26), high levels of airway neutrophils (OR 8.67, 95% CI 2.05–36.57), air flow obstruction (FEV1/FVC) (OR 1.61, 95% CI 1.21–2.14) and atopy (OR 11.54, 95% CI 1.97–67.70), were identified as independent risk factors associated with the air trapping phenotype. Quantitative CT determined air trapping in asthmatic subjects identifies a group of individuals with a high risk of severe disease. Several independent risk factors for the presence of this phenotype were identified, perhaps most interestingly history of pneumonia, neutrophilic inflammation, and atopy.
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影响因子：
19.7
作者：
Johnson, JL;Kramer, SS;Mahboubi, S
通讯作者：
Mahboubi, S
影响因子：
3.3
作者：
COXSON, HO;MAYO, JR;HOGG, JC
通讯作者：
HOGG, JC
影响因子：
3.3
作者：
HOFFMAN, EA
通讯作者：
HOFFMAN, EA
影响因子：
5
作者：
Huda, Walter;Vance, Awais
通讯作者：
Vance, Awais
DOI：
10.1164/ajrccm.159.3.9805067
发表时间：
1999-03-01
影响因子：
24.7
作者：
Coxson, HO;Rogers, RM;Hogg, JC
通讯作者：
Hogg, JC