Quantification of single-breath underestimation of lung volume in emphysema.

Quantification of single-breath underestimation of lung volume in emphysema.
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DOI:
10.1016/j.resp.2008.12.009
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发表时间:
2009-02-28
影响因子:
2.3
通讯作者:
Basner, Robert C.
Basner, Robert C.
中科院分区:
医学4区
文献类型:
--
作者:
Milite, Fulvia;Lederer, David J.;Weingarten, Jeremy A.;Fani, Pauline;Mooney, Anne M.;Basner, Robert C.

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单次呼吸测量在多大程度上代表肺气肿患者可用气体稀释和可压缩胸腔容积尚未量化。因此,我们测量了 55 名患有临床和放射学肺气肿的门诊患者以及 21 名正常对照者的单次呼吸 (TLCSB) 和再呼吸氦稀释 (TLCRB) 以及体积描记肺容量 (TLCpleth)。在肺气肿患者中,TLCSB 越来越低估 TLCpleth 和 TLCRB,因为 FEV1% 预测下降(两者交互作用 p = 0.001),TLCRB 平均下降 1.7 升(p < 0.001),TLCpleth 平均下降 2.2 升(p < 0.001)。相比之下,无论 FEV1%(交互作用的 p = 0.25)如何,TLCRB 均低估了 TLCpleth 0.5 升(p < 0.001)。 TLCSB、TLCRB 和 TLCpleth 在正常受试者中表现出很强的一致性。我们得出的结论是,随着生理性肺气肿严重程度的增加,TLCSB 低估了可用气体稀释和可压缩肺容量。相比之下,TLCRB 和 TLCpleth 显示出更接近的一致性,且不受生理性肺气肿严重程度的影响。
The extent to which a single breath measurement represents available gas dilutional as well as compressible thoracic volume in emphysema patients has not been quantified. We therefore measured single breath (TLCSB) and rebreathe helium dilution (TLCRB), and plethysmographic lung volume (TLCpleth), in fifty-five outpatients with clinical and radiographic emphysema, and in twenty-one normal controls. Among emphysema patients, TLCSB increasingly underestimated both TLCpleth and TLCRB as FEV1% predicted decreased (p for interaction = 0.001 for both) by a mean of 1.7 liters for TLCRB (p < 0.001) and 2.2 liters for TLCpleth (p < 0.001). In contrast, TLCRB underestimated TLCpleth by a mean of 0.5 liters (p < 0.001) regardless of FEV1% (p for interaction = 0.25). TLCSB, TLCRB, and TLCpleth showed strong agreement among normal subjects. We conclude that TLCSB underestimates available gas dilutional and compressible lung volume as physiologic emphysema severity increases. In contrast, TLCRB and TLCpleth show closer agreement which is unaffected by physiologic emphysema severity.
DOI: 10.1164/arrd.1978.118.4.685
发表时间: 1978-01-01
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发表时间: 1988-01-01
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