Dysanapsis and the Spirometric Response to Inhaled Bronchodilators.
Dysanapsis and the Spirometric Response to Inhaled Bronchodilators.
复制标题
呼吸衰竭和吸入支气管扩张剂的肺活量反应。
DOI：
10.1164/rccm.202107-1574le
复制
发表时间：
2021
影响因子：
24.7
通讯作者：
CanCOLDInvestigators
中科院分区：
文献类型：
--
作者：
Vameghestahbanati,Motahareh;Kirby,Miranda;Maltais,François;Jensen,Dennis;Doiron,Dany;Tan,WanC;Bourbeau,Jean;Smith,BenjaminM;CanCOLDInvestigators
方法受试者。这项名为COLD(加拿大阻塞性肺病)的流行研究利用人口普查数据，从9个社区(2005-2009年)随机抽取了40岁的非住院成年人作为样本。在2010-2014年间，正在进行的CanCOLD(加拿大队列阻塞性肺病)研究招募了患有COPD的感冒参与者，并且有代表性的随机分组的感冒不吸烟和吸烟的非COPD参与者在年龄和性别上匹配(6)。这项分析包括来自CanCOLD基线访问的数据。获得了机构审查委员会的批准，所有参与者都提供了书面知情同意。失语的CT评估。在螺旋扫描仪上按标准化方案进行全吸气CT扫描。在不知道其他参与者信息的情况下，使用Apollo软件(VIDA诊断软件)从CT图像中测量19个标准解剖位置(气管亚段)的气道腔直径和总肺容量。经过训练的读者获得的最低训练集评分员组内相关性为0.9(3)。呼吸紊乱被量化为以厘米为单位的气道管腔直径除以以立方厘米为单位的总肺体积的立方根(气道与肺的比率)。较低的气路/肺比表示较小的气道树/肺大小，较高的值表示较大的气道树/肺大小。二次呼吸困难的测量是根据参考公式计算的百分比预测的气道树口径，这些参考方程考虑了年龄、性别、身高和肺体积(3)，以及以厘米为单位的气道管腔直径的平均值。在吸入沙丁胺醇(沙丁胺醇)200 mg前和吸入后15分钟进行肺活量测定，沙丁胺醇从带间隔装置的计量吸入器吸入(100 mg/次)。参与者被告知在肺活量测定前6-24小时不要使用常规的吸入性药物，具体取决于药物类别。肺活量COPD由后支气管扩张剂FEV1/FVC，0.7(1)定义。计算FEV1(DFEV1)和FEV1/FVC(DFEV1/FVC)的支气管扩张剂相关变化为用药后减去用药前的值。其他变数。自我报告了年龄、性别、吸烟状况和经常吸入药物的使用情况。哮喘和慢性阻塞性肺疾病的临床诊断符合肯定的反应
MethodsParticipants. The COLD (Canadian Obstructive Lung Disease) prevalence study used census data to recruit a random sample of noninstitutionalized adults> 40 years old from nine communities (2005-2009). In 2010-2014, the ongoing CanCOLD (Canadian Cohort Obstructive Lung Disease) study enrolled COLD participants with COPD, and representative random subsets of COLD nonsmoking and smoking participants without COPD matched on age and sex (6). Data from the baseline CanCOLD visit were included in this analysis. Institutional review board approval was obtained, and all participants provided written informed consent. CT assessment of dysanapsis. Full-inspiration CT was performed on helical scanners according to a standardized protocol. Airway lumen diameters at 19 standard anatomic locations (tracheato-subsegments) and total lung volume were measured from CT images using Apollo Software (VIDA Diagnostics) by trained readers unaware of other participant information. Trained readers achieved a minimum training set interrater intraclass correlation of 0.9 (3). Dysanapsis was quantified as the mean of airway lumen diameters in centimeters divided by the cube root of total lung volume in cubic centimeters (airway-to-lung ratio). Lower values of airway-to-lung ratio indicate smaller airway tree-to-lung size, and higher values indicate larger airway tree-to-lung size. Secondary dysanapsis measures were percent-predicted airway tree caliber calculated from reference equations that account for age, sex, height, and lung volume (3), and the mean of airway lumen diameters in centimeters.Lung function. Spirometry was performed before and 15 minutes after inhalation of 200 mg of salbutamol (albuterol) that was administered from a metered-dose inhaler with spacer device (100 mg/actuation)(7). Participants were instructed to not use regular inhaled medications 6-24 hours before spirometry depending on medication class. Spirometric COPD was defined by post-bronchodilator FEV1/FVC, 0.7 (1). Bronchodilator-associated change in FEV1 (DFEV1) and FEV1/FVC (DFEV1/FVC) were calculated as post-bronchodilator minus prebronchodilator values. Other variables. Age, sex, cigarette smoking status, and regular inhaled medication use were self-reported. Clinical diagnoses of asthma and COPD corresponded to an affirmative response to