慢性气道疾病稳定期吸入药物能力与肺功能相关性

Correlation between the ability to inhale drugs and lung function in patients with chronic airway disease at stable stage

目的干粉吸入剂(DPI)的吸气流速是否达到最佳与药物疗效密切相关。本研究希望通过测定最大吸气峰值流速(PIF)来评估患者吸入药物能力,寻找PIF与肺功能指标之间相关性,指导患者选择有效的吸入装置。方法纳入慢性气道疾病稳定期患者。采用In-check Dial G16■装置记录PIF数值。同日完成肺功能或记录半年内稳定期肺功能数值。结果本研究共纳入168名稳定期慢性气道疾病患者,平均年龄(66.48±10.77)岁,平均BMI(23.56±3.75)kg/m^(2)。以PIF 60 L/min为界分两组,显示年龄、肺功能指标(VT、IRV、IC、VC_(max)、FVC、FEV_(1)、FEV_(1)/FVC、PEF、MEF_(75)、MEF_(50)、MEF_(25)、MEF_(75/25)、DLCO、TLC)组间比较,P<0.05;性别、BMI、肺功能指标(MV、ERV、RV、RV/TLC、FRC)组间比较,P>0.05。PIF与IC相关系数r=0.326,P<0.001,两者线性回归分析R^(2)值0.106,P<0.001。PIF<60 L/min时,IC对应AUC值为0.814,最佳界值1.27L,敏感度76.2%,特异度83.0%。结论本研究发现IC是影响PIF的因素之一,当IC<1.27L时,可能出现PIF达不到最佳的情况。需关注这类人群DPI使用情况,评估吸入药物能力,改善疾病预后。

Objective To evaluate the patient's ability to inhale drugs by measuring the maximum peak inspiratory flow rate(PIF),so as to find the correlation between PIF and pulmonary function indicators,and guide patients to choose an effective inhalation device.Methods Patients with stable chronic airway disease were included,and their PIF values were recorded using an In-check Dial G16■ device.The pulmonary function was completed on the same day or the pulmonary function value in the stable period within half a year was recorded.Results A total of 168 patients with stable chronic airway disease were included in this study,with an average age of(66.48±10.77)years old and an average BMI of(23.56±3.75)kg/m^(2).They were divided into two groups based on 60 L/min of PIF.There were significant differences in age and pulmonary function indicators(VT,IRV,IC,VC_(max),FVC,FEV_(1),FEV_(1)/FVC,PEF,MEF_(75),MEF_(50),MEF_(25),MEF_(75/25),DLCO,TLC)between the two groups(P<0.05).There was no significant difference in gender,BMI or pulmonary function indexes(MV,ERV,RV,RV/TLC,FRC)between the two groups(P>0.05).The correlation coefficient between PIF and IC was r=0.326(P<0.001),and the R^(2)value of the two linear regression analysis was 0.106(P<0.001).While PIF<60 L/min,the corresponding AUC value of IC was 0.814,the optimal cutoff value was 1.27L,the sensitivity was 76.2%,and the specificity was 83.0%.Conclusion This study find that IC is one of the factors affecting PIF.When IC<1.27L,PIF may not be optimal.It is necessary to pay attention to the use of DPI in this population,to evaluate the ability of inhaled drugs,and to improve the prognosis of the disease.