持续性哮喘患者呼吸系统阻力和电抗受损与支气管壁增厚相关
2023/02/01
摘要
研究背景：最近的一项研究表明，支气管活检气道重塑与定量计算机断层扫描看支气管壁厚度之间存在显著相关性。
研究目的：确定中重度哮喘患者支气管壁厚度的临床相关性。
实验方法：这项回顾性队列研究纳入了92名被呼吸科医生诊断为GINA定义的中度至重度哮喘患者。在对所有临床数据保密的情况下，两位资深胸腔放射科医生使用高分辨率CT成像技术独立测量了四个不同支气管肺段的气道腔和总气道面积。我们计算了支气管壁厚度与肺活量测定、振荡测定、病情加重和鼻息肉的关系的调整后的优势比（aORs）。
结果：对所有四个支气管肺段的汇总分析显示，AX≥1.0kPa/L、R5-R20比值≥25%、≥2 exac/yr和鼻息肉病与壁厚≥50%的关系的OR（95%CI）分别为3.54（1.22，10.32）；2.89（1.03，8.05）；4.17（1.25，13.90）；和9.85（2.33，41.74）。这些转化为壁面积≥50%的可能性分别增加72%、65%、76%和90%。
结论：持续性哮喘患者支气管壁厚度与外周气道阻力和阻力、严重恶化和鼻息肉有关。
Impaired respiratory system resistance and reactance are associated with bronchial wall thickening in persistent asthma
Chan, R., Duraikannu, C., Thouseef, M. J., & Lipworth, B. (2023)
Abstract
BACKGROUND:A recent study demonstrated a significant correlation between bronchial biopsy airway remodelling with quantitative computed tomography looking at bronchial wall thickness.
OBJECTIVES:To identify clinical associations with bronchial wall thickness in moderate-to-severe asthma.
METHODS:92 respiratory physician diagnosed GINA-defined moderate-to-severe asthma patients were included in this retrospective cohort study. Blinded to all clinical data, two senior thoracic radiologists independently measured airway lumen and total airway area at four different bronchopulmonary segments using high resolution CT imaging. We calculated adjusted odds ratios (aORs) in regard to the association of bronchial wall thickness with spirometry, oscillometry, exacerbations and nasal polyps.
RESULTS:The pooled analysis for all four bronchopulmonary segments showed that AX≥1.0kPa/L, R5-R20 ratio ≥25%, ≥2 exac/yr and nasal polyposis exhibited aOR (95%CI) of 3.54 (1.22,10.32); 2.89 (1.03,8.05); 4.17 (1.25,13.90); and 9.85 (2.33,41.74) respectively in their association with wall area thickness ≥50%. These translated into a respective 72%, 65%, 76% and 90% increased likelihood for wall area ≥50%.
CONCLUSION:Bronchial wall thickness is associated with peripheral airways resistance and reactance, severe exacerbations and nasal polyposis in persistent asthma.
研究背景：最近的一项研究表明，支气管活检气道重塑与定量计算机断层扫描看支气管壁厚度之间存在显著相关性。
研究目的：确定中重度哮喘患者支气管壁厚度的临床相关性。
实验方法：这项回顾性队列研究纳入了92名被呼吸科医生诊断为GINA定义的中度至重度哮喘患者。在对所有临床数据保密的情况下，两位资深胸腔放射科医生使用高分辨率CT成像技术独立测量了四个不同支气管肺段的气道腔和总气道面积。我们计算了支气管壁厚度与肺活量测定、振荡测定、病情加重和鼻息肉的关系的调整后的优势比（aORs）。
结果：对所有四个支气管肺段的汇总分析显示，AX≥1.0kPa/L、R5-R20比值≥25%、≥2 exac/yr和鼻息肉病与壁厚≥50%的关系的OR（95%CI）分别为3.54（1.22，10.32）；2.89（1.03，8.05）；4.17（1.25，13.90）；和9.85（2.33，41.74）。这些转化为壁面积≥50%的可能性分别增加72%、65%、76%和90%。
结论：持续性哮喘患者支气管壁厚度与外周气道阻力和阻力、严重恶化和鼻息肉有关。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2023 Jan 10. DOI: 10.1016/j.jaip.2022.12.040)
(J Allergy Clin Immunol Pract. 2023 Jan 10. DOI: 10.1016/j.jaip.2022.12.040)
Impaired respiratory system resistance and reactance are associated with bronchial wall thickening in persistent asthma
Chan, R., Duraikannu, C., Thouseef, M. J., & Lipworth, B. (2023)
Abstract
BACKGROUND:A recent study demonstrated a significant correlation between bronchial biopsy airway remodelling with quantitative computed tomography looking at bronchial wall thickness.
OBJECTIVES:To identify clinical associations with bronchial wall thickness in moderate-to-severe asthma.
METHODS:92 respiratory physician diagnosed GINA-defined moderate-to-severe asthma patients were included in this retrospective cohort study. Blinded to all clinical data, two senior thoracic radiologists independently measured airway lumen and total airway area at four different bronchopulmonary segments using high resolution CT imaging. We calculated adjusted odds ratios (aORs) in regard to the association of bronchial wall thickness with spirometry, oscillometry, exacerbations and nasal polyps.
RESULTS:The pooled analysis for all four bronchopulmonary segments showed that AX≥1.0kPa/L, R5-R20 ratio ≥25%, ≥2 exac/yr and nasal polyposis exhibited aOR (95%CI) of 3.54 (1.22,10.32); 2.89 (1.03,8.05); 4.17 (1.25,13.90); and 9.85 (2.33,41.74) respectively in their association with wall area thickness ≥50%. These translated into a respective 72%, 65%, 76% and 90% increased likelihood for wall area ≥50%.
CONCLUSION:Bronchial wall thickness is associated with peripheral airways resistance and reactance, severe exacerbations and nasal polyposis in persistent asthma.
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支气管哮喘气道平滑肌重塑的异质性
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肥胖和肥胖性哮喘的外周气道功能障碍
