Maximal mid-expiratory flow detects early lung disease in xcexb11-antitrypsin deficiency

[摘要] Pathological studies suggest that loss of small airways precedes airflow obstruction and emphysema in chronic obstructive pulmonary disease (COPD). Not all xcexb11-antitrypsin deficiency (AATD) patients develop COPD; and measures of small airways function might be able to detect those at risk.Maximal mid-expiratory flow (MMEF); forced expiratory volume in 1 s (FEV1); ratio of FEV1/forced vital capacity (FVC); health status; presence of emphysema (computed tomography (CT) densitometry) and subsequent decline in FEV1 were assessed in 196 AATD patients.FEV1/FVC; FEV1 % predicted and lung densitometry related to MMEF % pred (r2=0.778; p<0.0001; r2=0.787; p<0.0001; r2=0.594; p<0.0001; respectively) in a curvilinear fashion. Patients could be divided into those with normal FEV1/FVC and MMEF (group 1); normal FEV1/FVC and reduced MMEF (group 2) and those with spirometrically defined COPD (group 3). Patients in group 2 had worse health status than group 1 (median total St George's Respiratory Questionnaire (SGRQ) 23.15 (interquartile range (IQR) 7.09xe2x80x9339.63) versus 9.67 (IQR 1.83xe2x80x9322.35); p=0.006) and had a greater subsequent decline in FEV1 (median change in FEV1 xe2x88x921.09% pred per year (IQR xe2x88x921.91xe2x80x930.04% pred per year) versus xe2x88x920.04% pred per year (IQR xe2x88x920.67xe2x80x930.03% pred per year); p=0.007).A reduction in MMEF is an early feature of lung disease in AATD and is associated with impaired health status and a faster decline in FEV1.

[学科分类] 呼吸医学