Maximal mid-expiratory flow is a surrogate marker of lung clearance index for assessment of adults with bronchiectasis.
Maximal mid-expiratory flow is a surrogate marker of lung clearance index for assessment of adults with bronchiectasis.
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DOI：
10.1038/srep28467
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发表时间：
2016-06-24
影响因子：
4.6
通讯作者：
Zhong NS
中科院分区：
文献类型：
--
作者：
Guan WJ;Yuan JJ;Gao YH;Li HM;Zheng JP;Chen RC;Zhong NS
肺清除指数（LCI）和最大呼气中期流量（MMEF）在支气管扩张症中的诊断价值的对比研究知之甚少。我们比较了支气管扩张急性加重（BE）期间LCI和MMEF%预测值的诊断性能、与临床变量的相关性和一致性以及变化。对稳定期支气管扩张患者进行病史询问、胸部高分辨率CT（HRCT）、多次呼吸氮洗脱试验、肺功能测定和痰培养。发生BE的患者在BE发作期间和抗生素治疗后1周进行这些测量。对轻度、中度和重度支气管扩张进行敏感性分析。我们在2014年3月至2015年9月期间招募了110名支气管扩张症患者。LCI在区分中度至重度支气管扩张和轻度支气管扩张方面显示出与MMEF%预测值相似的诊断价值。LCI与MMEF%预测值呈负相关。两项指标在反映支气管扩张临床特征方面具有相似的一致性，并与1秒用力呼气流量、年龄、HRCT评分、铜绿假单胞菌定植、囊性支气管扩张、通气异质性和双侧支气管扩张显著相关。在急性加重队列（n = 22）中，BE期间和抗生素治疗后LCI和MMEF%预测值的变化同样极小。在敏感性分析中，两个参数具有相似的诊断价值和与临床变量的相关性。MMEF%预测值是评估支气管扩张严重程度的LCI的替代指标。
Little is known about the comparative diagnostic value of lung clearance index (LCI) and maximal mid-expiratory flow (MMEF) in bronchiectasis. We compared the diagnostic performance, correlation and concordance with clinical variables, and changes of LCI and MMEF% predicted during bronchiectasis exacerbations (BEs). Patients with stable bronchiectasis underwent history inquiry, chest high-resolution computed tomography (HRCT), multiple-breath nitrogen wash-out test, spirometry and sputum culture. Patients who experienced BEs underwent these measurements during onset of BEs and 1 week following antibiotics therapy. Sensitivity analyses were performed in mild, moderate and severe bronchiectasis. We recruited 110 bronchiectasis patients between March 2014 and September 2015. LCI demonstrated similar diagnostic value with MMEF% predicted in discriminating moderate-to-severe from mild bronchiectasis. LCI negatively correlated with MMEF% predicted. Both parameters had similar concordance in reflecting clinical characteristics of bronchiectasis and correlated significantly with forced expiratory flow in one second, age, HRCT score, Pseudomonas aeruginosa colonization, cystic bronchiectasis, ventilation heterogeneity and bilateral bronchiectasis. In exacerbation cohort (n = 22), changes in LCI and MMEF% predicted were equally minimal during BEs and following antibiotics therapy. In sensitivity analyses, both parameters had similar diagnostic value and correlation with clinical variables. MMEF% predicted is a surrogate of LCI for assessing bronchiectasis severity.