Forced oscillation technique for early detection of the effects of smoking and COPD: contribution of fractional-order modeling.
Forced oscillation technique for early detection of the effects of smoking and COPD: contribution of fractional-order modeling.
复制标题
DOI：
10.2147/copd.s173686
复制
发表时间：
2018
影响因子：
2.8
通讯作者：
de Melo PL
中科院分区：
文献类型：
--
作者：
Ribeiro CO;Faria ACD;Lopes AJ;de Melo PL
本研究的目的是评估强迫振荡技术 (FOT) 在吸烟和慢性阻塞性肺病影响的早期诊断中的性能。还评估了整数阶 (InOr) 和分数阶 (FrOr) 模型的贡献。总共对 120 名受试者进行了分析：40 名对照者、40 名吸烟者（20.3±9.3 包年）和 40 名轻度慢性阻塞性肺病患者。最初，人们观察到传统的 FOT 参数以及 InOr 和 FrOr 模型提供了对 COPD 病理生理学的一致描述。轻度 COPD 导致 FrOr 惯性、阻尼因子和迟滞性显着增加 (P<0.0001)。这些参数与中央气道和小气道阻塞的肺活量参数显着相关（P<0.0001）。诊断准确性分析表明，FOT 参数和 InOr 建模可以充分识别这些变化（受试者工作特征曲线下面积 – AUC >0.8）。 FrOr 模型的使用显着改善了这一过程（P<0.05），从而可以高精度地早期诊断吸烟者和轻度 COPD 患者（AUC >0.9）。 FrOr 建模提高了我们对 COPD 早期阶段发生的变化的了解。此外，本研究的结果证明这些模型可能在慢性阻塞性肺病的早期诊断中发挥重要作用，这对于改善该疾病的临床管理至关重要。
The aim of the present study was to evaluate the performance of the forced oscillation technique (FOT) for the early diagnosis of the effects of smoking and COPD. The contributions of the integer-order (InOr) and fractional-order (FrOr) models were also evaluated. In total, 120 subjects were analyzed: 40 controls, 40 smokers (20.3±9.3 pack-years) and 40 patients with mild COPD. Initially, it was observed that traditional FOT parameters and the InOr and FrOr models provided a consistent description of the COPD pathophysiology. Mild COPD introduced significant increases in the FrOr inertance, damping factor and hysteresivity (P<0.0001). These parameters were significantly correlated with the spirometric parameters of central and small airway obstruction (P<0.0001). The diagnostic accuracy analyses indicated that FOT parameters and InOr modeling may adequately identify these changes (area under the receiver operating characteristic curve – AUC >0.8). The use of FrOr modeling significantly improved this process (P<0.05), allowing the early diagnosis of smokers and patients with mild COPD with high accuracy (AUC >0.9). FrOr modeling improves our knowledge of modifications that occur in the early stages of COPD. Additionally, the findings of the present study provide evidence that these models may play an important role in the early diagnosis of COPD, which is crucial for improving the clinical management of the disease.