Role of impulse oscillometry in chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap

IF 4.6 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2025-04-22 DOI:10.1002/clt2.70057

Yuning Huang, Xue Zhang, Jinwen Wang, Wuping Bao, Chengjian Lv, Yingying Zhang, Xue Tian, Yan Zhou, Min Zhang

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引用次数: 0

Abstract

Background

Small airway dysfunction (SAD) is critical in chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO), impacting disease severity, acute exacerbation (AE) risk, and prognosis. Traditional spirometry may miss SAD due to its reliance on forced vital capacity.

Objective

This study investigates the role of impulse oscillometry system (IOS) for early detection, disease monitoring, and AE prediction.

Methods

Pathological specimens from 64 patients with normal lung function were divided into small airway pathological abnormalities (PAs, n = 38) and normal pathology (PN, n = 26). Logistic regression and receiver operating characteristic (ROC) curve analysis evaluated IOS's predictive value for SAD. Additionally, 37 healthy volunteers, 125 COPD patients, and 128 ACO patients underwent spirometry, IOS, FeNO, CT scans, and blood tests. Correlations between IOS and spirometry indices were evaluated. One-year follow-up of 140 patients assessed IOS's predictive capability for AE.

Results

ROC analysis indicated that R5 − R20 combined with FEF₇₅%pred best predicted PAs (areas under the ROC curves [AUC] = 0.80). R5 − R20, with a cut-off of 0.09 kPa/[L/s], demonstrated 85.6% sensitivity and 72.9% specificity in distinguishing COPD from healthy individuals, and 89.1% sensitivity with 72.9% specificity for ACO. In COPD, R5 − R20 correlated strongly with spirometry indices (r = 0.60), while Fres correlated well in ACO (r = 0.48) for FEV₁%pred ≥ 50%, with slightly weaker correlations for FEV₁%pred < 50%. For predicting AE, a model combining R5 − R20, FEV₁%Pred and body mass index had an AUC of 0.860 in COPD, while a model with Fres, FEV₁%pred and fraction of exhaled nitric oxide achieved an AUC of 0.874 in ACO.

Conclusions

IOS is valuable for early detection, monitoring, and AE prediction in COPD and ACO, enhancing diagnostic precision.

Clinical Trial Registration

No. ChiCTR2400089625, www.chictr.org.cn.

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脉冲振荡测量法在慢性阻塞性肺病和哮喘-慢性阻塞性肺病重叠中的作用

背景小气道功能障碍（SAD）在慢性阻塞性肺疾病（COPD）和哮喘-慢性阻塞性肺疾病重叠症（ACO）中至关重要，会影响疾病的严重程度、急性加重（AE）风险和预后。传统的肺活量测定法由于依赖于用力肺活量，可能会漏诊 SAD。本研究探讨了脉冲振荡测量系统（IOS）在早期检测、疾病监测和 AE 预测中的作用。方法将 64 例肺功能正常患者的病理标本分为小气道病理异常（PA，38 例）和正常病理（PN，26 例）。逻辑回归和接收器操作特征（ROC）曲线分析评估了 IOS 对 SAD 的预测价值。此外，37 名健康志愿者、125 名慢性阻塞性肺病患者和 128 名 ACO 患者接受了肺活量测定、IOS、FeNO、CT 扫描和血液检查。评估了 IOS 和肺活量指数之间的相关性。对 140 名患者进行的一年随访评估了 IOS 对 AE 的预测能力。结果 ROC 分析表明，R5 - R20 与 FEF75%pred 结合对 PA 的预测效果最佳（ROC 曲线下面积 [AUC] = 0.80）。R5 - R20 的临界值为 0.09 kPa/[L/s]，在区分慢性阻塞性肺病和健康人方面的灵敏度为 85.6%，特异度为 72.9%；在区分 ACO 方面的灵敏度为 89.1%，特异度为 72.9%。在慢性阻塞性肺病中，R5 - R20 与肺活量指数的相关性很强（r = 0.60），而在 ACO 中，Fres 与 FEV1%pred ≥ 50% 的相关性很好（r = 0.48），与 FEV1%pred < 50% 的相关性稍弱。在预测 AE 方面，结合 R5 - R20、FEV1%pred 和体重指数的模型在 COPD 患者中的 AUC 为 0.860，而结合 Fres、FEV1%pred 和呼出一氧化氮分数的模型在 ACO 患者中的 AUC 为 0.874。结论 IOS 对慢性阻塞性肺病和 ACO 的早期检测、监测和 AE 预测很有价值，可提高诊断的精确性。临床试验注册号：ChiCTR2400089625，www.chictr.org.cn。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.