Forced oscillation technique may identify severe asthma
Forced oscillation technique may identify severe asthma
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强制振荡技术可以识别严重哮喘
DOI：
10.1016/j.jaip.2019.05.036
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Hashimoto Shu
中科院分区：
文献类型：
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作者：
Shirai Toshihiro;Hirai Keita;Gon Yasuhiro;Maruoka Shuichiro;Mizumura Kenji;Hikichi Mari;Itoh Kunihiko;Hashimoto Shu
研究表明，在一些但不是所有严重哮喘患者中观察到固定气流阻塞。1，2除了症状控制不佳和频繁的严重急性发作外，气流受限也被纳入ERS/ATS重度哮喘指南中未控制哮喘的标准。3严重哮喘的固定气流阻塞通常通过肺量测定来评估。然而，强迫振荡技术（FOT）的作用是未知的。FOT用于测量潮气呼吸期间的呼吸系统阻力（Rrs）和电抗（Xrs），并提供无法通过肺活量测定法获得的信息。我们假设FOT有助于诊断重度哮喘并将其与非重度哮喘区分开来。这项横断面研究评估了FOT在诊断重度哮喘中的作用。研究对象包括255名成年哮喘患者，他们在2013年2月至2016年8月期间连续前往静冈综合医院或日本大学板桥医院门诊进行常规检查。如果患者在入组时病情加重或在研究前至少1个月内发生任何急性病毒感染，则将其从研究中排除。不能进行FOT或肺功能测定的患者也被排除在研究之外。在检查当天，研究受试者依次接受血液检查、呼出一氧化氮（FeNO）分数、FOT和肺功能测定分析。外周血嗜酸性粒细胞和嗜中性粒细胞计数、总IgE（ImmunoCAP系统; Phadia，Uppsala，Sweden）、血清骨膜蛋白（Elecsys Periostin测定; Roche Professional Diagnostics，Penzberg，德国）和几丁质酶-3-样蛋白1（YKL-40）（人几丁质酶3-样1 Quantikine ELISA试剂盒，目录号DC 3L 10; R&D Systems，Inc.，Minneapolis，Minn）进行测量。FeNO通过在线方法在50 mL/s的流速下测量，
Studies indicate that fixed airflow obstruction is observed in some but not all patients with severe asthma. 1, 2 In addition to poor symptom control and frequent severe exacerbations, airflow limitation is included in the criteria of uncontrolled asthma in the ERS/ATS severe asthma guidelines. 3 Fixed airflow obstruction in severe asthma is usually assessed by spirometry. However, the role of the forced oscillation technique (FOT) is unknown. The FOT is used to measure respiratory system resistance (Rrs) and reactance (Xrs) during tidal breathing and provides information that cannot be obtained by spirometry. 4 We hypothesized that FOT would be useful to diagnose severe asthma and discriminate it from nonsevere asthma. This cross-sectional study assessed the usefulness of FOT in diagnosing severe asthma. The study subjects included 255 adult patients with asthma who visited outpatient clinics at Shizuoka General Hospital or Nihon University Itabashi Hospital consecutively for routine check-ups between February 2013 and August 2016. Patients were excluded from the study if they had an exacerbation at entry or had any acute viral infection within at least 1 month before the study. Patients who could not perform the FOT or spirometry were also excluded from the study. On the examination day, the study subjects underwent blood tests, fractional exhaled nitric oxide (FeNO), FOT, and spirometry analysis in that order. The peripheral blood eosinophil and neutrophil counts, total IgE (ImmunoCAP system; Phadia, Uppsala, Sweden), serum periostin (Elecsys Periostin assay; Roche Professional Diagnostics, Penzberg, Germany), and chitinase-3-like protein 1 (YKL-40)(Human Chitinase 3-like 1 Quantikine ELISA Kit, catalogue number DC3L10; R&D Systems, Inc., Minneapolis, Minn) were measured. FeNO was measured via an online method at a flow rate of 50 mL/s using an