A Short extension to multiple breath washout provides additional signal of distal airway disease in people with CF: A pilot study
A Short extension to multiple breath washout provides additional signal of distal airway disease in people with CF: A pilot study
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多次呼吸冲洗的短期延长为 CF 患者提供了远端气道疾病的额外信号：一项试点研究
DOI：
10.1016/j.jcf.2021.06.013
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发表时间：
2022
影响因子：
5.2
通讯作者：
Short C
中科院分区：
文献类型：
--
作者：
Short C
背景在多次呼吸洗脱（MBW）中加入慢肺活量（SVC）可以量化通气不足/不通气肺单位（UVLU）的信号，并且可以提供比传统肺清除指数更全面的气道疾病评估（LCI2.5）。方法我们对接受MBW测试的人进行了一项试点研究：10名健康对照（HC）和43名囊性纤维化（CF）受试者在标准测试结束后进行SVC。我们称这种新的结果为LCI与短期扩展（LCIShX）。我们评估了（i）CF/ HC差异，（ii）变异性（iii）肺恶化（PEX）/治疗的影响和（iv）与CF计算机断层扫描（CFCT）scores.ResultsHC/ CF组的差异较大，LCIShX比LCI2.5（P<0.001）。在CF组中，UVLU是高度可变的，当异常时，它与相应的LCI 2.5不相关。在临床稳定性期间，信号显示出很小的变异性（n= 11 CF; 2次访视;中位试验间变异性2.6% LCI 2.5）。对于发作和消退，LCIShX的PEx信号显著更大。这两个MBW参数显着相关的总肺CT评分和过度充气，但只有LCIShX相关的粘液plugging.ConclusionsUVLU内捕获的LCIShX个体之间的变化;缺乏与LCI2.5的关系表明，新的，额外的信息被捕获。临床稳定性期间LCIShX的可重复性及其在PEx发作周围的较大信号可能使其作为结局指标具有上级灵敏度。进一步的研究将建立在这一试点数据的基础上，以充分确定其在监测疾病状况方面的效用。
BackgroundAdding a slow vital capacity (SVC) to multiple breath washout (MBW) allows quantification of otherwise overlooked signal from under/un-ventilated lung units (UVLU) and may provide a more comprehensive assessment of airway disease than conventional lung clearance index (LCI2.5).MethodsWe conducted a pilot study on people undergoing MBW tests: 10 healthy controls (HC) and 43 cystic fibrosis (CF) subjects performed an SVC after the standard end of test. We term the new outcome LCI with Short extension (LCIShX). We assessed (i) CF/ HC differences, (ii) variability (iii) effect of pulmonary exacerbation (PEx)/treatment and (iv) relationship with CF computed tomography (CFCT) scores.ResultsHC/ CF group differences were larger with LCIShXthan LCI2.5(P<0.001). Within the CF group UVLU was highly variable and when abnormal it did not correlate with corresponding LCI2.5. Signal showed little variability during clinical stability (n= 11 CF; 2 visits; median inter-test variability 2.6% LCIShX,2.5% LCI2.5). PEx signal was significantly greater for LCIShXboth for onset and resolution. Both MBW parameters correlated significantly with total lung CT scores and hyperinflation but only LCIShXcorrelated with mucus plugging.ConclusionsUVLU captured within the LCIShXvaries between individuals; the lack of relationship with LCI2.5demonstrates that new, additional information is being captured. LCIShXrepeatability during clinical stability combined with its larger signal around episodes of PEx may lend it superior sensitivity as an outcome measure. Further studies will build on this pilot data to fully establish its utility in monitoring disease status.