Clinical Value of Impulse Oscillometry in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM Respiration Pub Date : 2024-10-03 DOI:10.1159/000541633

Junjie Peng, Xiaohua Li, Hong Zhou, Tao Wang, Xiaoou Li, Lei Chen

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Abstract

Introduction: Impulse oscillometry (IOS) is an effortless test compared to spirometry. Numerous studies explored the role of IOS in spirometry-based chronic obstructive pulmonary disease (COPD), but most of them had limited sample sizes with poor statistical power. This systematic review and meta-analysis aimed to pool the individual data and quantitatively analyze the clinical value of IOS in COPD.

Methods: PubMed, Web of Science, Ovid, Cochrane Library, China National Knowledge Internet, and Wanfang were searched for studies with comparisons of IOS indicators between COPD patients and healthy controls, including respiratory resistance at 5 Hz (R5) and 20 Hz (R20), difference between R5 and R20 (R5-R20), respiratory reactance at 5 Hz (X5), resonant frequency (Fres), and area of reactance (Ax). Meta-analyses were conducted to calculate the weighted mean differences (WMDs) and 95% confidence intervals (CIs).

Results: 39 eligible studies were enrolled, involving 6,144 COPD patients and 4,611 healthy controls. Relative to healthy controls, COPD patients had significantly higher R5 (WMD: 0.17, 95% CI: 0.14, 0.20), R5-R20 (WMD: 0.13, 95% CI: 0.11, 0.15), Fres (WMD: 9.04, 95% CI: 7.66, 10.42), Ax (WMD: 1.24, 95% CI: 0.86, 1.61), and lower X5 (WMD: -0.15, 95% CI: -0.18, -0.11), and such differences became even greater as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage escalated. Pooled correlation coefficients presented that R5, R5-R20, Fres, and X5 were significantly related to post-bronchodilator forced expiratory volume in the first second (FEV1)/forced vital capacity ratio (meta r = -0.37, -0.45, -0.53, and 0.42, respectively) and FEV1 as a percentage of predicted value (meta r = -0.43, -0.54, -0.59, and 0.56, respectively).

Conclusion: IOS may be a supplement to spirometry in diagnosing and assessing COPD, especially when spirometry is inappropriate. More well-designed, large sample-sized, prospective studies are warranted to establish an IOS-based criterion for COPD management.

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脉冲振荡测量法在慢性阻塞性肺病中的临床价值：系统回顾和荟萃分析。

简介与肺活量测定法相比，脉冲振荡测定法（IOS）是一种毫不费力的测试方法。许多研究探讨了 IOS 在基于肺活量测定的慢性阻塞性肺病（COPD）中的作用，但大多数研究的样本量有限，统计能力较差。本系统综述和荟萃分析旨在汇集个体数据，定量分析 IOS 在慢性阻塞性肺病中的临床价值：方法：检索了PubMed、Web of Science、Ovid、Cochrane Library、中国知网和万方数据库中有关COPD患者和健康对照组IOS指标比较的研究，包括5Hz（R5）和20Hz（R20）的呼吸阻力、R5和R20的差值（R5-R20）、5Hz的呼吸反应（X5）、共振频率（Fres）和反应面积（Ax）。通过元分析计算加权平均差（WMDs）和 95% 置信区间（CIs）：结果：共纳入 39 项符合条件的研究，涉及 6144 名慢性阻塞性肺病患者和 4611 名健康对照者。与健康对照组相比，慢性阻塞性肺病患者的 R5（WMD：0.17，95% CI：0.14，0.20）、R5-R20（WMD：0.13，95% CI：0.11，0.15）、Fres（WMD：9.04，95% CI：7.66，10.42）、Ax（WMD：1.24，95% CI：0.86，1.61）和较低的 X5（WMD：-0.15，95% CI：-0.18，-0.11），随着慢性阻塞性肺病全球倡议（GOLD）阶段的升级，这种差异变得更大。汇总相关系数显示，R5、R5-R20、Fres 和 X5 与支气管扩张后第一秒用力呼气容积（FEV1）/用力肺活量（FVC）比值（meta r = -0.37、-0.45、-0.53 和 0.42）和 FEV1 占预测值的百分比（FEV1% pred）（meta r = -0.43、-0.54、-0.59 和 0.56）显著相关：结论：在诊断和评估慢性阻塞性肺病时，IOS 可以作为肺活量测定的补充，尤其是在肺活量测定不合适的情况下。需要进行更多精心设计、大样本量的前瞻性研究，以建立基于 IOS 的慢性阻塞性肺病管理标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.