Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
Department of Hospital Internal Medicine, Northwest A&F University, Yangling, Shanxi 712100, China.
Sci Rep. 2016 Nov 23;6:37550. doi: 10.1038/srep37550.
Chronic obstructive pulmonary disease (COPD) is a chronic airway disease characterized by persistent airflow limitation. Moreover, lung hyperinflation evaluated by lung volumes is also the key pathophysiologic process during COPD progression. Nevertheless, there is still no preferred method to evaluate lung volumes. For this study, we recruited 170 patients with stable COPD to assess lung volumes stratified by airflow limitation severity. Lung volumes including residual volume (RV) and total lung capacity (TLC) were determined by both body plethysmography and helium dilution methods. The discrepancies between these two methods were recorded as ΔRV%pred, ΔTLC%pred, and ΔRV/TLC. We found that ΔRV%pred, ΔTLC%pred, and ΔRV/TLC increased significantly with the severity of COPD. The differences of lung capacity between these two methods were negatively correlated with FEV%pred, and diffusing capacity for carbon monoxide (DCO%pred). Moreover, the receiver operating characteristic (ROC) for ΔTLC%pred to distinguish severe COPD from non-severe COPD had an area under curve (AUC) of 0.886. The differences of lung volume parameters measured by body plethysmography and helium dilution methods were associated with airflow limitation and can effectively differentiate COPD severity, which may be a supportive method to assess the lung function of stable COPD patients.
慢性阻塞性肺疾病(COPD)是一种慢性气道疾病,其特征是持续存在的气流受限。此外,肺容积评估的肺过度充气也是 COPD 进展过程中的关键病理生理过程。然而,仍然没有首选的方法来评估肺容积。在这项研究中,我们招募了 170 名稳定期 COPD 患者,根据气流受限严重程度对肺容积进行分层评估。肺容积包括残气量(RV)和肺总量(TLC),通过体描仪和氦稀释法来确定。这两种方法之间的差异记录为 ΔRV%pred、ΔTLC%pred 和 ΔRV/TLC。我们发现,ΔRV%pred、ΔTLC%pred 和 ΔRV/TLC 随着 COPD 的严重程度显著增加。这两种方法测量的肺容量差异与 FEV%pred 和一氧化碳弥散量(DCO%pred)呈负相关。此外,ΔTLC%pred 区分严重 COPD 和非严重 COPD 的受试者工作特征(ROC)曲线下面积(AUC)为 0.886。体描仪和氦稀释法测量的肺容积参数之间的差异与气流受限有关,并且可以有效地区分 COPD 的严重程度,这可能是评估稳定期 COPD 患者肺功能的一种支持性方法。