A Systematic Review of the Use of Physiological Tests Assessing the Acute Response to Treatment During Exacerbations of COPD (with a Focus on Small Airway Function).
A Systematic Review of the Use of Physiological Tests Assessing the Acute Response to Treatment During Exacerbations of COPD (with a Focus on Small Airway Function).
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系统评价使用生理测试评估 COPD 恶化期间对治疗的急性反应（重点关注小气道功能）。
DOI：
10.1080/15412555.2020.1815183
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发表时间：
2020
期刊：
影响因子：
2.2
通讯作者：
Alobaidi NY
中科院分区：
文献类型：
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作者：
Alobaidi NY
慢性阻塞性肺疾病 (COPD) 患者的病情加重普遍存在，并且与不良的临床结果相关。目前，缺乏能够客观识别病情加重并评估其进展或治疗反应的敏感且具体的工具。 FEV1 通常作为一项研究结果进行报告，但它有很大的局限性。研究表明，小气道测量可能会在病情恶化期间提供生理生物标志物。因此，本研究的目的是评估哪些小气道功能的生理测试已在慢性阻塞性肺病恶化期间的急性环境中使用，以及支持其使用的证据。 2019 年 4 月进行了电子数据库检索。使用了标准系统评价方法。符合资格的研究是指≥10名参与者参与的研究，这些研究将至少一项小气道测试与FEV1进行比较，以评估基线治疗的反应以及≤2个月后的随访测量。分析是叙述性的。在 1436 项筛选研究中，有 7 项研究符合资格。使用小气道测试和报告三种不同的小气道测量存在异质性。研究规模较小（包括 20 至 87 名受试者）。六篇文章报告了从恶化恢复期间小气道测量值的改善，这与 FEV1 相关。纳入的研究的评估时间和持续时间各不相同。有一些证据支持在慢性阻塞性肺病急性加重时使用小气道测试。然而，研究规模较小，使用了不同的测试。进一步研究以确定每个测试的有用性可能会令人感兴趣。
Exacerbations are prevalent in Chronic Obstructive Pulmonary Disease (COPD) patients and associated with poor clinical outcomes. Currently, there is a lack of sensitive and specific tools that can objectively identify exacerbations and assess their progress or treatment response. FEV1is often reported as a study outcome, but it has significant limitations. Studies have suggested that small airways measures might provide physiological biomarkers during exacerbations. Therefore, this study was done to assess which physiological tests of small airways function have been used in the acute setting during exacerbations of COPD and the evidence to support their use. An electronic databases search was conducted in April 2019. A standard systematic review methodology was used. Eligible studies were those of ≥10 participants that compared at least one small airway test with FEV1to assess response to treatment with baseline and a follow-up measurement ≤2 months after. Analyses were narrative. Of 1436 screened studies, seven studies were eligible. There was heterogeneity in which tests of small airways were used and three different small airways measures were reported. Studies were small (including 20 to 87 subjects). Six articles reported improvements in small airway measurements during the recovery from exacerbation which correlated with FEV1. Included studies varied in their timing and duration of the assessment. There is some evidence to support the use of small airway tests in acute exacerbations of COPD. However, studies have been small with different tests being utilized. Further studies to determine the usefulness of each test may be of interest.