Journal of Diagnostics Concepts & Practice >

2019 , Vol. 18 >Issue 04: 418 - 422

DOI: https://doi.org/10.16150/j.1671-2870.2019.04.007

Original articles

Analysis of the influence of airway resistance on expiratory flow limitation in COPD patients with stable GOLD stages Ⅱ-Ⅲ

Expand
  • 1. Department of Respiratory Medicine, The Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
    2. Department of Respiratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040 China
    3. Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080 China

Received date: 2018-12-18

  Online published: 2019-08-25

Fold

Abstract

Objective: To study the correlation between airway resistance (Raw) and expiratory flow limitation (EFL) in patients with chronic obstructive pulmonary disease (COPD). Methods: One hundred and two stable Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages Ⅱ-Ⅲ COPD patients, of them 53 were stage Ⅱ and 49 were stage Ⅲ, were enrolled. Patients were not taking bronchodilator eight hours before examination, then lung function testing and respiratory airway resistance were measured after salbutamol (400 μg) inhalation. Twenty eight healthy subjects were served as controls. Results: The peak expiratory flow (PEF), peak expiratory flow (PEF) and forced expiratory flow at 50% forced vital capacity (FEF50) in stage Ⅲ COPD patients were significantly lower than those in stage Ⅱ COPD patients. Seven (14.3%) patients with stage Ⅲ COPD and only 1 (1.9%) patients with stage Ⅱ COPD revealed inspiratory fraction [ratio of inspiratory capacity and total lung capacity (IC/TLC)] ≤25%. The total airway resistance (Rtot), effective airway resistance (Reff), inspiratory airway resistance/expiratory airway resistance (Rinsp/Rexp) of the two COPD groups were significantly higher than those of the control group. The Rexp of COPD patients had the best correlation with FEV1, PEF and FEF50 (all r>0.80, P<0.01). Conclusions: Raw especially Rexp is already obviously increased in stable moderate to severe COPD patients on account of the severe expiratory flow limitation. Peripheral component of air way resistance might be the main factor of the increment. The symptom of dyspnea would be prone to appear with the deterioration of lung function.

Key words： Chronic obstructive pulmonary disease; Flow limitation; Airway resistance; Inspiratory fraction

Cite this article

CHEN Yuqing, WANG Mingjie, ZHU Dong, LV Chengjian, CHEN Ping . Analysis of the influence of airway resistance on expiratory flow limitation in COPD patients with stable GOLD stages Ⅱ-Ⅲ[J]. Journal of Diagnostics Concepts & Practice, 2019 , 18(04) : 418 -422 . DOI: 10.16150/j.1671-2870.2019.04.007

References

[1] Shen YC, Chen L, Wen FQ. [Inter[retation of 2019 Glo-bal Strategy for the Diagnosis, Management and Prevention of chronic Obstructive Pulmonary Disease][J]. Zhonghua Yi Xue Za Zhi, 2018, 98(48):3913-3916.
[2] McDonough JE, Yuan R, Suzuki M, et al. Small-airway obstruction and emphysema in chronic obstructive pulmonary disease[J]. N Engl J Med, 2011, 365(17):1567-1575.
[3] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013年修订版)[J]. 中华结核和呼吸杂志, 2013, 36(4):255-264.
[4] 中华医学会呼吸病学分会肺功能专业组. 肺功能检查指南(第二部分)——肺量计检查[J]. 中华结核和呼吸杂志, 2014, 37(7):481-486.
[5] 中华医学会呼吸病学分会肺功能专业组. 肺功能检查指南——体积描记法肺容量和气道阻力检查[J]. 中华结核和呼吸杂志, 2015, 38(5): 342-347.
[6] Urbankowski T, Przybyłowski T. Methods of airway resistance assessment[J]. Pneumonol Alergol Pol, 2016, 84(2):134-141.
[7] Bestall JC, Paul EA, Garrod R, et al. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease[J]. Thorax, 1999, 54(7):581-586.
[8] Morrison NJ, Richardson J, Dunn L, et al. Respiratory muscle performance in normal elderly subjects and patients with COPD[J]. Chest, 1989, 95(1):90-94.
[9] Celli B, ZuWallack R, Wang S, et al. Improvement in resting inspiratory capacity and hyperinflation with tiotropium in COPD patients with increased static lung volumes[J]. Chest, 2003, 124(5):1743-1748.
[10] Casanova C, Cote C, de Torres JP, et al. Inspiratory-to-total lung capacity ratio predicts mortality in patients with chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2005, 171(6):591-597.
[11] Albuquerque ALP, Nery LE, Villaca DS, et al. Inspiratory fraction and exercise impairment in COPD patients GOLD stages Ⅱ-Ⅲ. Eur Respir J, 2006, 28(5):939-944. PMID: 16870665 DOI: 10.1183/09031936.06.00040506
[12] 田志宏, 王金平. 两种气道阻力检测方法的比较[J]. 医疗卫生装备, 2004, 25(12):51.
[13] Topalovic M, Derom E, Osadnik CR, et al. Airways resistance and specific conductance for the diagnosis of obstructive airways diseases[J]. Respir Res, 2015, 16:88.
[14] DuBois AB, Botelho SY, Comroe JH Jr. A new method for measuring airway resistance in man using a body plethysmograph: values in normal subjects and in patients with respiratory disease[J]. J Clin Invest, 1956, 35(3):327-335.
[15] Fisher AB, DuBois AB, Hyde RW. Evaluation of the forced oscillation technique for the determination of resistance to breathing[J]. J Clin Invest, 1968, 47(9):2045-2057.
[16] Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests[J]. Eur Respir J, 2005, 26(5):948-968.
[17] Mahut B, Trinquart L, Bokov P, et al. Relationships between specific airway resistance and forced expiratory flows in asthmatic children[J]. PLoS One, 2009, 4(4): e5270.
[18] Bokov P, Mauroy B, Revel MP, et al. Lumen areas and homothety factor influence airway resistance in COPD[J]. Respir Physiol Neurobiol, 2010, 173(1):1-10.
Options
Outlines

/

〈 〉