Clinical characteristics of airway impairment assessed by impulse oscillometry in patients with chronic obstructive pulmonary disease: findings from the ECOPD study in China

BMC Pulmonary Medicine

Research

Xiang Wen¹  Huajing Yang¹  Youlan Zheng¹  Shan Xiao¹  Ningning Zhao¹  Xiaohui Wu¹  Jianwu Xu¹  Cuiqiong Dai¹  Lifei Lu¹  Kunning Zhou¹  Zhishan Deng¹  Jieqi Peng²  Yumin Zhou²  Pixin Ran²  Fan Wu² 

[1] State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, China;State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, China;Guangzhou Laboratory, Guangzhou, China;

关键词: Impulse oscillometry;    Airway impairment;    Chronic obstructive pulmonary disease;    Computed tomography;    Spirometry;   

DOI  :  10.1186/s12890-023-02311-z

 received in 2022-09-07, accepted in 2023-01-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe role of airway impairment assessed by impulse oscillometry (IOS) in patients with chronic obstructive pulmonary disease (COPD) remains unclear. Therefore, this study aimed to analyze the proportion and clinical characteristics of airway impairment assessed by IOS across COPD severities, and explore whether airway impairment is a subtype of COPD.MethodsThis study was based on cross-sectional data from the ECOPD cohort in Guangdong, China. Subjects were consecutively recruited from July 2019 to August 2021. They filled out questionnaires and underwent lung function tests, IOS and computed tomography (CT). COPD was defined as post-bronchodilator forced expiratory volume in one second/forced vital capacity < lower limit of normal (LLN). Meanwhile, airway impairment was defined as IOS parameters > upper limit of normal or < LLN. On the one hand, Poisson regression was employed to analyze the associations between acute exacerbations of COPD (AECOPD) in the previous year and airway impairment. On the other hand, logistic regression was used to assess differences in CT imaging between patients with IOS parameters’ abnormalities and patients with normal IOS parameters.Results768 COPD subjects were finally enrolled in the study. The proportion of airway impairment assessed by R5, R20, R5–R20, X5, AX, and Fres was 59.8%, 29.7%, 62.5%, 52.9%, 60.9% and 67.3%, respectively. Airway impairment assessed by IOS parameters (R5, R5–R20, X5, AX, and Fres) in patients with COPD was present across all severities of COPD, particularly in GOLD 3–4 patients. Compared with patients with normal IOS parameters, patients with IOS parameters’ abnormalities had more respiratory symptoms, more severe airway obstruction and imaging structural abnormalities. Patients with IOS parameters’ abnormalities assessed by R5 [risk ratio (RR): 1.58, 95% confidential interval (CI): 1.13–2.19, P = 0.007], R5–R20 [RR: 1.73, 95%CI: 1.22–2.45, P = 0.002], X5 [RR: 2.11, 95%CI: 1.51–2.95, P < 0.001], AX [RR: 2.20, 95%CI: 1.53–3.16, P < 0.001], and Fres [RR: 2.13, 95%CI: 1.44–3.15, P < 0.001] had a higher risk of AECOPD in the previous year than patients with normal IOS parameters.ConclusionsAirway impairment assessed by IOS may be a subtype of COPD. Future studies are warranted to identify the underlying mechanisms and longitudinal progression of airway impairment.

【 授权许可】

CC BY   
© The Author(s) 2023

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