Application of impulse oscillometry lung function test in risk assessment of deterioration in COPD patients
Objective To explore the application value of impulse oscillometry lung function test(IOS)in the risk as-sessment of deterioration in chronic obstructive pulmonary disease(COPD).Methods A total of 184 patients with COPD were selected,and the frequency of acute exacerbation of COPD(AECOPD)within 1 year was used to evaluate the risk of deterioration in COPD patients;COPD patients were divided into the non-frequent attack group(AECOPD attack≤1 time/year,81 cases)and frequent attack group(AECOPD attack≥2 times/year,103 cases).Routine pulmonary function test(PFT)was performed in all patients at stable stage.PFT parameters were measured,including forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),the ratio of the actual value of FVC to the predicted value(FVC%pred),the percentage of forced expiratory volume in the first second to its predicted value(FEV1%pred),instantaneous expiratory flow at 50%of forced expiratory vital capacity(FEF50%),instantaneous expiratory flow at 75%of forced expira-tory vital capacity(FEF75%),peak expiratory flow(PEF),and mid-expiratory flow during forced expiratory flow(MMEF).The severity of airway obstruction was graded according to FEV1%pred(GOLD classification);the IOS parame-ters were detected,including the total respiratory impedance at the oscillation frequency of 5 Hz(Z5),the reactance at the oscillation frequency of 5 Hz(X5),the percentage of the reactance to its predicted value at the oscillation frequency of 5 Hz(X5%pred),the total airway resistance at the oscillation frequency of 5 Hz(R5),the percentage of the total airway resis-tance to its predicted value at the oscillation frequency of 5 Hz(R5%pred),the airway resistance at the oscillation frequency of 20 Hz(R20),the airway resistance difference at the oscillation frequency of 5 and 20 Hz(R5-R20),ΔR5-R20[100×(R5-R20)/R20],and response frequency(Fres;X5 and R5 were used to classify the severity of airway obstruction.The modified British Medical Research Council Respiratory Questionnaire(mMRC)was used to evaluate the degree of dyspnea,and the COPD Assessment Test(CAT)questionnaire was used to evaluate the quality of life of patients.Pearson correla-tion method was used to analyze the correlation between each index.Results The PFT parameters such as FEV1,FVC,FVC%pred,FEV1/FVC,FEV1%pred,FEF50%,FEF75%,PEF and MMEF in the frequent attack group were lower than those in the non-frequent attack group(all P<0.05).There was a statistically significant difference in GOLD classification between the non-frequent attack group and the frequent attack group(P<0.05).The IOS parameters such as Z5,X5,X5%pred,R5,R5%pred,R20,R5-R20,ΔR5-R20 and Fres in the frequent attack group were higher than those in the non-frequent attack group(all P<0.05).There was a statistically significant difference in IOS grading between the non-fre-quent attack group and the frequent attack group(P<0.05).The scores of mMRC and CAT in the frequent attack group were higher than those in the non-frequent attack group(both P<0.05).Z5,X5%pred,R5,R5%pred,R20,R5-R20,ΔR5-R20,Fres were negatively correlated with FEV1,FVC,FVC%pred,FEV1/FVC,FEV1%pred,FEF50%,FEF75%,PEF,MMEF,mMRC score,and CAT score in COPD patients(all P<0.05).X5 was positively correlated with FEV1,FVC,FVC%pred,FEV1/FVC,FEV1%pred,FEF50%,FEF75%,PEF,MMEF,mMRC score and CAT score(all P<0.05).Conclusion IOS can be used to evaluate the risk of deterioration in patients with COPD.
chronic obstructive pulmonary diseasesmall airway dysfunctionimpulse oscillometry lung function testrisk of deterioration
万方数据
维普
