Table_1_The Role of Impulse Oscillometry in Evaluating Disease Severity and Predicting the Airway Reversibility in Patients With Bronchiectasis.DOCX

BackgroundImpulse oscillometry (IOS) can be used to evaluate airway impedance in patients with obstructive airway diseases. Previous studies have demonstrated that IOS parameters differ between patients with bronchiectasis and healthy controls. This study aims to explore the usefulness of IOS in assessing disease severity and airway reversibility in patients with bronchiectasis.
MethodSeventy-four patients with non-cystic fibrosis bronchiectasis who visited our Respiratory Medicine outpatient clinic were consecutively recruited. Spirometry, plethysmography and IOS tests were performed. Patients were stratified into mild, moderate and severe disease according to Reiff, Bhalla, BSI, FACED, and BRICS scores. Airway reversibility was measured by bronchodilation test (BDT) and the result was classified as positive or negative. ROC curves of IOS parameters were used to assess the usefulness of IOS parameters in predicting airway reversibility. Correlations between the IOS, spirometric lung function and bronchiectasis severity parameters were analyzed.
ResultsMany IOS parameters, such as airway resistance at 5 Hz (R5), small airways resistance (R5–R20), total airway reactance (X5), resonance frequency (Fres), total airway impedance at 5 Hz (Z5), and peripheral resistance (Rp) increased in patients with bronchiectasis who presented a moderate to severe severity as categorized by the FACED, BSI and Reiff scores. Large airway resistance (R20) and central resistance (Rc) were not significantly different among groups with different bronchiectasis severity. The difference between R5 and R20 (R5-R20) showed 81.0% sensitivity, and 69.8%specificity in predicting the airway reversibility in bronchiectasis with AUC of 0.794 (95%CI, 0.672–0.915).
ConclusionIOS measurements are useful indicators of bronchiectasis severity and may be useful for predicting the airway reversibility.

背景 脉冲振荡肺功能（Impulse oscillometry, IOS）可用于评估阻塞性气道疾病患者的气道阻抗。既往研究已证实，支气管扩张症患者与健康对照者的IOS参数存在差异。本研究旨在探讨IOS在评估支气管扩张症患者疾病严重程度及气道可逆性方面的应用价值。
方法 连续纳入就诊于本院呼吸内科门诊的74例非囊性纤维化性支气管扩张症患者。所有受试者均接受肺量测定、体积描记及IOS检测。依据Reiff、Bhalla、BSI、FACED及BRICS评分将患者分为轻度、中度及重度疾病组。采用支气管舒张试验（bronchodilation test, BDT）评估气道可逆性，结果分为阳性与阴性。通过IOS参数的受试者工作特征（Receiver Operating Characteristic, ROC）曲线，评估IOS参数在预测气道可逆性方面的应用价值。分析IOS参数与肺量测定肺功能指标、支气管扩张症严重程度评分之间的相关性。
结果 依据FACED、BSI及Reiff评分划分为中至重度的支气管扩张症患者，其多项IOS参数均升高，包括5Hz气道阻力（airway resistance at 5 Hz, R5）、小气道阻力（small airways resistance, R5–R20）、总气道电抗（total airway reactance, X5）、共振频率（resonance frequency, Fres）、5Hz总气道阻抗（total airway impedance at 5 Hz, Z5）及外周阻力（peripheral resistance, Rp）。不同支气管扩张症严重程度组间的大气道阻力（large airway resistance, R20）与中心气道阻力（central resistance, Rc）无显著差异。R5与R20的差值（R5-R20）在预测支气管扩张症气道可逆性时，敏感度为81.0%，特异度为69.8%，曲线下面积（Area Under the Curve, AUC）为0.794（95%置信区间，0.672–0.915）。
结论 IOS检测可作为评估支气管扩张症严重程度的有效指标，或可用于预测气道可逆性。