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Clinical application value of impulse oscillometry in geriatric patients with COPD

机译:脉冲示波法在老年COPD患者中的临床应用价值

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Background: The diagnosis and assessment of COPD rely mainly on the use of spirometry, which is an effort-dependent test and requires good patient cooperation. Impulse oscillometry (IOS) is a non-volitional method that requires less effort and cooperation and presents advantages for geriatric patients. However, the clinical application value of IOS in geriatric patients with COPD remains unclear. Aim: The aim of this study was to investigate the clinical application value of IOS in geriatric patients with COPD. Subjects and methods: A total of 234 subjects were retrospectively enrolled in this study, including 133 patients with COPD and 101 healthy volunteers. All the participants underwent IOS and spirometry examination. The data were collected and analyzed in the overall group, the geriatric group (aged ≥65?years), and the advanced elderly group (aged ≥80?years). Results: 1) In COPD patients, a significant increase in respiratory impedance (Z5), resonant frequency (Fres), and respiratory resistance (R5, R20, R5–R20) and a decrease in respiratory reactance (X5) were observed in the overall group, the geriatric group, and the advanced elderly group compared with the healthy control subjects. 2) The IOS parameters correlated well with spirometry in COPD. In particular, R5–R20 showed the best correlation with forced expiratory volume in 1?second (FEV1) in the different age groups. 3) Fres and R5–R20 had the best diagnostic efficiency for COPD. The area under the curve (AUC) values for Fres, expressed by the receiver operating characteristic (ROC) curve, were 0.905, 0.909, and 0.914, for the different age groups, respectively. 4) The optimal cutoff values for Fres to diagnose airflow obstruction from ROC curves was 17.715 in the COPD patients. Its sensitivity and specificity were 0.789 and 0.931, respectively, and the cutoff values were similar in geriatric and advanced elderly patients. Conclusion: IOS demonstrated good relevance compared with spirometry for geriatric patients with COPD. IOS may serve as an alternative method for spirometry in elderly subjects for the evaluation of the state of COPD.
机译:背景:COPD的诊断和评估主要依靠肺活量测定法,这是一种依赖于努力的测试,需要患者的良好配合。脉冲示波法(IOS)是一种非自愿性方法,需要较少的精力和合作,并且对老年患者具有优势。然而,IOS在老年COPD患者中的临床应用价值仍不清楚。目的:本研究旨在探讨IOS在老年COPD患者中的临床应用价值。受试者和方法:回顾性纳入本研究的234名受试者,包括133名COPD患者和101名健康志愿者。所有参与者均接受了IOS和肺活量检查。整个组,老年组(≥65岁)和老年老年组(≥80岁)均收集并分析了数据。结果:1)在COPD患者中,总体上观察到呼吸阻抗(Z5),共振频率(Fres)和呼吸阻力(R5,R20,R5-R20)显着增加,呼吸电抗降低(X5)。组,老年组和高龄老人组与健康对照组相比。 2)IOS参数与COPD中的肺活量测定法密切相关。特别是,R5–R20在不同年龄组中与1秒内的强迫呼气量(FEV 1 )表现出最佳的相关性。 3)Fres和R5-R20对COPD的诊断效率最高。由接收者工作特征(ROC)曲线表示的Fres曲线下面积(AUC)值,对于不同年龄组分别为0.905、0.909和0.914。 4)在COPD患者中,Fres从ROC曲线诊断气流阻塞的最佳临界值为17.715。其敏感性和特异性分别为0.789和0.931,在老年和晚期老年患者中,其临界值相似。结论:与肺活量测定法相比,IOS对老年COPD患者具有良好的相关性。 IOS可以作为老年受试者肺活量测定的替代方法,用于评估COPD的状态。

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