哮喘联盟

   摘要
   背景和目的：氙通气计算机断层成像（CT）用于评估哮喘患者局部区域的通风状况已显示出一定潜力。本研究的目的旨在评估氙通气CT在管理中老年哮喘患者中的实用性。
   方法：试验纳入初治65岁以上老年哮喘患者。药物治疗开始前，先进行一系列检测，检测包括使用支气管扩张剂（BD）的可逆性肺功能检查、包括视觉模拟评分法（VAS）在内的用于评估症状严重程度的问卷调查、认知功能和情绪的评估测试、以及氙气通风CT检查。氙气通风CT中氙气捕捉（XT）代表吸入氙气未排出而被捕捉到的区域。治疗12周后，对症状和肺功能再次进行检测。
   结果：研究纳入39例老年哮喘患者。BD洗脱前，由VAS测量的呼吸困难的严重程度与氙通气CT中XT区域总数量显著相关（r=-0.723，P<0.001）。吸入BD后，XT区域总数量显著下降，基线XT区域总数量（BD洗脱前后）的差异与随后的抗哮喘治疗中1秒用力呼气体积增加百分比显示出显著的相关性（r=-0.775，P<0.001）。
   结论：疝气通风CT在检测老年哮喘患者呼吸困难和预测治疗应答方面可能是个客观和有前途的工具。
 

（苏楠 审校）
Respirology. 2014 Feb 11. doi: 10.1111/resp.12242. [Epub ahead of print]

 

Xenon ventilation computed tomography and the management of asthma in the elderly.
 

Park HW, Jung JW, Kim KM, Kim TW, Lee SH, Lee CH, Goo JM, Min KU, Cho SH.
 

Abstract
BACKGROUND AND OBJECTIVE: Xenon ventilation computed tomography (CT) has shown potential in assessing the regional ventilation status in subjects with asthma. The purpose of this study was to evaluate the usefulness of xenon ventilation CT in the management of asthma in the elderly.
METHODS: Treatment-naïve asthmatics aged 65 years or older were recruited. Before initiation of medication, spirometry with bronchodilator (BD) reversibility, questionnaires to assess the severity of symptoms including a visual analogue scale (VAS), tests to evaluate cognitive function and mood, and xenon ventilation CT were performed. Xenon gas trapping (XT) on xenon ventilation CT represents an area where inhaled xenon gas was not expired and was trapped. Symptoms and lung functions were measured again after the 12-week treatment.
RESULTS: A total of 30 elderly asthmatics were enrolled. The severity of dyspnoea measured by the VAS showed a significant correlation with the total number of areas of XT on the xenon ventilation CT taken in the pre-BD wash-out phase (r = -0.723, P < 0.001). The total number of areas of XT significantly decreased after BD inhalation, and differences in the total number of areas of XT (between the pre- and post-BD wash-out phases) at baseline showed significant correlations with the per cent increases in forced expiratory volume in 1 s after subsequent anti-asthma treatment (r = -0.775, P < 0.001).
CONCLUSIONS: Xenon ventilation CT may be an objective and promising tool in the measurement of dyspnoea and prediction of the treatment response in elderly asthmatics.
 

Respirology. 2014 Feb 11. doi: 10.1111/resp.12242. [Epub ahead of print