dlco

DLCO
  • 文章类型: Journal Article
    目的:已知肺癌与慢性阻塞性肺疾病有关。此外,营养状况与慢性阻塞性疾病治疗和肺癌有关。我们的目的是评估COPD状态与非小细胞肺癌治疗的相互作用。方法:82例患者纳入我们的多中心研究。慢性阻塞性疾病阶段,记录肺活量测定和治疗以及治疗和体重指数(BMI),地中海饮食评分,包年,基本代谢(RMR)(千卡/天),血氧饱和度(ml/min),Ve(lt/min)和身体活动。使用JMP14.3(SASInc2018)软件进行统计分析。结果:48例患者的药物对显示出稳定且随时间变化的健康状况。总的来说,记录了31例COPD健康状况较差的患者。单因素方差分析清楚地表明,化疗诱导了最佳的FEV1差异条件,平均FEV体积为8.56,联合治疗根本没有效果(-0.9),而免疫治疗和接受放疗的患者的FEV1体积降低至-4.23和-5.15平均值。结论:仅接受化疗的患者,其慢性阻塞性疾病的改善与较少的药物和加重,虽然接受免疫治疗的患者的慢性阻塞性疾病稳定,而所有其他治疗组合都使患者的慢性阻塞性疾病恶化。营养状况不会以任何方式影响这些患者的慢性阻塞性疾病。
    Objectives: Lung cancer is known to be associated with chronic obstructive pulmonary disease. Moreover; nutritional status is associated with chronic obstructive disease treatment and lung cancer. Our aim was to evaluate the interaction of the COPD status and treatment of non-small cell lung cancer. Methods: Eighty-two patients were enrolled in our multicenter study. Chronic obstructive disease stage, spirometry and treatment was recorded along with the treatment and Body Mass Index (BMI), Mediterranian Diet Score, Pack Years, Basic Metabolsim (RMR) (kcal/day), VO₂ (ml/min), Ve (lt/min) and Physical Activity. The statistical analysis was performed using the JMP 14.3 (SAS Inc 2018) software. Results: The drug pairs showed a steady and unchanged by time health condition for 48 patients. Overall, 31 patients were recorded with worse COPD health conditions. The one-way ANOVA clearly indicated that chemotherapy induced the best FEV1-difference conditions with a positive effect of 8.56 mean FEV volume, the combined treatment simply did not have an effect (-0.9), while immunotherapy and patients receiving radiation decreased their FEV1 volume down to -4.23 and -5.15 mean values. Conclusions: Patients receiving chemotherapy alone had their chronic obstructive disease improved with less drugs and exacerbations, while patients receiving immunotherapy had their chronic obstructive disease stable, while all other treatment combinations worsened the patients chronic obstructive disease. Nutritional status did not affect the chronic obstructive disease of these patients in any way.
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  • 文章类型: Randomized Controlled Trial
    特发性肺纤维化(IPF)是一种具有显著死亡率的进行性疾病。迫切需要识别快速进展者的预后生物标志物来改善患者管理。由于溶血磷脂酸(LPA)途径在临床前模型中与肺纤维化有关,并被确定为潜在的治疗靶标,我们旨在研究生物活性脂质LPA是否可以作为预测IPF疾病进展的预后生物标志物.使用定量LPA测定和LipidyzerTM在一项随机IPF对照试验的基线安慰剂血浆中测量LPAs和脂质组学,分别。血脂与包括肺功能下降在内的疾病指标的关联,恶化,使用统计模型评估死亡和影像学进展.与健康相比,IPF患者的5种LPA(LPA16:0、16:1、18:1、18:2、20:4)水平显着升高,两种甘油三酯(TAG)水平降低(TAG48:4-FA12:0和-FA18:2)(FDR<0·05,倍数变化>2)。LPA水平较高的患者在52周内DLCO下降幅度更大(p<0.01);与LPA20:4低(<中位数)亚组相比,LPA20:4高(≥中位数)患者的恶化时间更早(风险比(95%CI):LPA20:4高=5·71(1·17-27·72)(p=0·031)。较高的基线LPAs与72周时高分辨率计算机断层扫描量化的下肺纤维化增加有关(p<0·05)。这些LPA中的一些与促纤维化巨噬细胞的生物标志物呈正相关(CCL17、CCL18、OPN、和YKL40)和肺上皮损伤(sRAGE和SPD)(p<0·05)。我们的研究建立了IPF患者LPAs与疾病进展的关系,进一步支持LPA途径在IPF病理生物学中的作用。
    Idiopathic pulmonary fibrosis (IPF) is a progressive disease with significant mortality. Prognostic biomarkers to identify rapid progressors are urgently needed to improve patient management. Since the lysophosphatidic acid (LPA) pathway has been implicated in lung fibrosis in preclinical models and identified as a potential therapeutic target, we aimed to investigate if bioactive lipid LPA species could be prognostic biomarkers that predict IPF disease progression. LPAs and lipidomics were measured in baseline placebo plasma of a randomized IPF-controlled trial. The association of lipids with disease progression indices were assessed using statistical models. Compared to healthy, IPF patients had significantly higher levels of five LPAs (LPA16:0, 16:1, 18:1, 18:2, 20:4) and reduced levels of two triglycerides species (TAG48:4-FA12:0, -FA18:2) (false discovery rate < 0.05, fold change > 2). Patients with higher levels of LPAs had greater declines in diffusion capacity of carbon monoxide over 52 weeks (P < 0.01); additionally, LPA20:4-high (≥median) patients had earlier time to exacerbation compared to LPA20:4-low (
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  • 文章类型: Journal Article
    COVID-19幸存者的长期预后仍然知之甚少。事实证明,肺是COVID-19幸存者的主要受损器官,最明显的是肺弥散功能受损。因此,我们对恢复期COVID-19患者一氧化碳弥散能力(DLCO)受损的潜在危险因素进行了荟萃分析.
    我们对PubMed进行了系统搜索,WebofScience,Embase,和Ovid数据库从开始到2022年1月7日的相关研究,仅限于涉及人类受试者的论文。对方法学质量的研究进行了综述。使用固定效应和随机效应模型来汇集结果。使用I2评估异质性。使用Egger检验评估发表偏倚。PROSPERO注册:CRD42021265377。
    共确定了18篇合格文章,并将其纳入系统评价,12项研究纳入荟萃分析.我们的结果显示,女性(OR:4.011;95%CI:2.928-5.495),改变的胸部计算机断层扫描(CT)(OR:3.002;95%CI:1.319-6.835),年龄(OR:1.018;95%CI:1.007-1.030),较高的D-二聚体水平(OR:1.012;95%CI:1.001-1.023)和尿素氮(OR:1.004;95%CI:1.002-1.007)被确定为DLCO受损的危险因素.
    肺弥散能力是COVID-19康复患者中最常见的肺功能受损。几个危险因素,比如女性,胸部CT改变,年龄较大,较高的D-二聚体水平和尿素氮与DLCO的损害相关。提高对可能的可改变的危险因素的认识和实施干预措施对于肺康复可能是有价值的。
    这项工作得到了广州实验室应急重点项目(EKPG21-29,EKPG21-31)的资助,广州医科大学国家杰出青年科学基金孵化计划(GMU2020-207).
    UNASSIGNED: The long-term prognosis of COVID-19 survivors remains poorly understood. It is evidenced that the lung is the main damaged organ in COVID-19 survivors, most notably in impairment of pulmonary diffusion function. Hence, we conducted a meta-analysis of the potential risk factors for impaired diffusing capacity for carbon monoxide (DLCO) in convalescent COVID-19 patients.
    UNASSIGNED: We performed a systematic search of PubMed, Web of Science, Embase, and Ovid databases for relevant studies from inception until January 7, 2022, limited to papers involving human subjects. Studies were reviewed for methodological quality. Fix-effects and random-effects models were used to pool results. Heterogeneity was assessed using I2. The publication bias was assessed using the Egger\'s test. PROSPERO registration: CRD42021265377.
    UNASSIGNED: A total of eighteen qualified articles were identified and included in the systematic review, and twelve studies were included in the meta-analysis. Our results showed that female (OR: 4.011; 95% CI: 2.928-5.495), altered chest computerized tomography (CT) (OR: 3.002; 95% CI: 1.319-6.835), age (OR: 1.018; 95% CI: 1.007-1.030), higher D-dimer levels (OR: 1.012; 95% CI: 1.001-1.023) and urea nitrogen (OR: 1.004;95% CI: 1.002-1.007) were identified as risk factors for impaired DLCO.
    UNASSIGNED: Pulmonary diffusion capacity was the most common impaired lung function in recovered patients with COVID-19. Several risk factors, such as female, altered chest CT, older age, higher D-dimer levels and urea nitrogen are associated with impairment of DLCO. Raising awareness and implementing interventions for possible modifiable risk factors may be valuable for pulmonary rehabilitation.
    UNASSIGNED: This work was financially supported by Emergency Key Program of Guangzhou Laboratory (EKPG21-29, EKPG21-31), Incubation Program of National Science Foundation for Distinguished Young Scholars by Guangzhou Medical University (GMU2020-207).
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  • 文章类型: Journal Article
    背景:第一波COVID-19大流行于2020年10月正式开始。此后,对该疾病及其症状进行了多次观察。
    方法:我们在观察性研究中纳入了87项。我们的主要目的是调查他们的长期呼吸随访与其最初的放射学和实验室发现以及价值的相关性。COVID-19的鼻拭子PCR检测用于诊断。患者在入院后3个月和6个月接受监测,而健康状况的基本参数(吸烟,PO2,SPO2,WBC,CXR,CRP,并发发现,护理的日子,秋水仙碱给药)结合性别和年龄进行记录。
    结果:男性似乎比女性更容易患病毒性疾病,比例为1,8:1。参数FEV1和FVC(以相对变化百分比表示)未受影响,除了对CRP(在loge1转化中)和SPO2的DLCO显示出统计学上的显着影响。
    结论:这些患者均未插管,或者被送进重症监护室.呼吸道功能受到病毒的影响,并且在前三个月内效果会逆转。男性受影响更大,放射学和实验室检查结果与呼吸功能有关。
    BACKGROUND: The first wave of the COVID-19 pandemic initiated officially in October 2020. Since then several observations have been made regarding the disease and its symptoms.
    METHODS: We included eighty seven in our observational study. Our main aim was to investigate their long term respiratory follow-up in correlation with their initial radiological and laboratory findings and values. The nose swab PCR test for COVID-19 was used for diagnosis. Patients were monitored at 3 and 6 months after their hospital reception whereas basic parameters of health condition (smoking, PO2, SPO2, WBC, CXR, CRP, intercurrent findings, days of nursing, colchicine administration) in joint with gender and age were recorded.
    RESULTS: Males seem more susceptible to the viral disease than females in a ratio 1,8:1. The parameters FEV1 and FVC (as % relative changes) were not affected, apart from the DLCO to which CRP (in loge+1 transformation) and SPO2 showed a statistically significant effect.
    CONCLUSIONS: None of these patients were intubated, or admitted to the intensive care unit. The respiratory function is affected by the virus and the effect is reversed within the first three months. Males are more affected and the radiological and laboratory findings are associated with the respiratory functions.
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  • 文章类型: Journal Article
    背景:确定COVID-19相关住院后患者的呼吸道转归。方法:对文献进行系统评价和荟萃分析。结果:强迫肺活量(FVC,预测的百分比):出院后0-3个月:96.1,95%CI[82.1-110.0];出院后3-6个月:99.9,95%CI[84.8,115.0];出院后>6个月:97.4,95%CI[76.8-118.0]。肺部对一氧化碳的扩散能力(DLCO,预测的百分比):出院后0-3个月:83.9,95%CI[68.9-98.9];出院后3-6个月:91.2,95%CI[74.8-107.7];出院后>6个月:97.3,95%CI[76.7-117.9]。FVC小于80%的患者预测:出院后0-3个月:10%,95%CI[6-14%];出院后3-6个月:10%,95%CI[2-18%];出院后>6个月:13%,95%CI[8-18%]。DLCO小于80%的患者预测:出院后0-3个月:48%,95%CI[41-56%];出院后3-6个月:33%,95%CI[23-44%];出院后>6个月:43%,95%CI[22-65%]。结论:荟萃分析证实,在COVID-19相关住院患者中,持续性肺弥散障碍的患病率很高。因此,强烈建议进行常规呼吸随访。
    Background: To determine the respiratory outcomes in patients following COVID-19-related hospitalization. Methods: Systematic review and meta-analysis of the literature. Results: Forced vital capacity (FVC, % of predicted): 0-3 months post discharge: 96.1, 95% CI [82.1-110.0]; 3-6 months post discharge: 99.9, 95% CI [84.8, 115.0]; >6 months post discharge: 97.4, 95% CI [76.8-118.0]. Diffusing capacity of the lungs for carbon monoxide (DLCO, % of predicted): 0-3 months post discharge: 83.9, 95% CI [68.9-98.9]; 3-6 months post discharge: 91.2, 95% CI [74.8-107.7]; >6 months post discharge: 97.3, 95% CI [76.7-117.9]. Percentage of patients with FVC less than 80% of predicted: 0-3 months post discharge: 10%, 95% CI [6-14%]; 3-6 months post discharge: 10%, 95% CI [2-18%]; >6 months post discharge: 13%, 95% CI [8-18%]. Percentage of patients with DLCO less than 80% of predicted: 0-3 months post discharge: 48%, 95% CI [41-56%]; 3-6 months post discharge: 33%, 95% CI [23-44%]; >6 months post discharge: 43%, 95% CI [22-65%]. Conclusion: The meta-analysis confirms a high prevalence of persistent lung diffusion impairment in patients following COVID-19-related hospitalization. Routine respiratory follow-up is thus strongly recommended.
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  • 文章类型: Journal Article
    背景:原发性干燥综合征(pSS)是一种慢性系统性自身免疫性疾病,其特征是典型的自身抗体产生和淋巴细胞介导的外分泌腺损伤。间质性肺病(ILD)是pSS的常见并发症,可能与预后不良有关。然而,ILD在pSS中的发病机制尚不清楚。方法:在本研究中,我们使用RNA测序研究了36例ILD-pSS患者和128例非ILD-pSS患者的小唾液腺(MSG)的基因表达谱.结果:在显著富集的趋化因子介导的信号通路中,C-X-C基序趋化因子受体2(CXCR2),白细胞介素-8的受体,参与中性粒细胞的激活,发现与pSS患者的MSG和血浆均显着升高无ILD(p<0.001)。此外,CXCR2在MSG和血浆中的表达水平与肺对一氧化碳的扩散能力显著相关,红细胞沉降率,ILD-pSS中的EULARSjögren综合征疾病活动指数。结论:因此,它在pSS患者ILD进展中的潜在作用及其与疾病临床表现的强烈关联,CXCR2可作为与pSS相关的ILD疾病活动的有用指标。
    Background: Primary Sjögren\'s syndrome (pSS) is a chronic systemic autoimmune disease characterized by typical autoantibody production and lymphocytic-mediated exocrine gland damage. Interstitial lung disease (ILD) is a common complication of pSS and can be associated with a poor prognosis. However, the pathogenesis of ILD in pSS is still unclear. Methods: In this study, we used RNA sequencing to investigate the gene-expression profile of the minor salivary glands (MSGs) from 36 patients with ILD-pSS and 128 patients with non-ILD-pSS. Results: In the remarkably enriched chemokine-mediated signaling pathway, C-X-C motif chemokine receptor 2 (CXCR2), a receptor for interleukin-8, which participates in the activation of neutrophils, was found to be significantly elevated in both MSG and plasma from pSS patients with vs. without ILD (p < 0.001). Furthermore, the CXCR2 expression level in MSG and plasma was significantly associated with the diffusing capacity of the lungs for carbon monoxide, erythrocyte sedimentation rate, and EULAR Sjögren\'s Syndrome disease Activity Index in ILD-pSS. Conclusion: Therefore, with its potential role in ILD progression in patients with pSS and its strong association with clinical manifestations of the disease, CXCR2 may serve as a useful index for disease activity in ILD associated with pSS.
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  • 文章类型: Journal Article
    Expression of β2-microglobulin (β2M) is involved in fibrosis progression in kidney, liver, and heart. In this case-controlled retrospective study, we investigated the role of β2M in the development of pulmonary fibrosis in patients with chronic obstructive pulmonary disease (COPD). Analysis of 450 COPD patients revealed that patients with decreased pulmonary diffusing capacity (DLCO) had increased β2M serum levels. Compared to patients with lower β2M serum levels, patients with increased β2M levels exhibited increased alveolar wall/septal thickening and lung tissue β2M expression. In addition, patients with increased β2M levels had increased lung expression of TGF-β1, Smad4, and a-SMA. Animal experiments showed that increased β2M expression resulted in epithelial-mesenchymal transition (EMT), alveolar wall/septal thickening, and pulmonary fibrosis in a rat COPD model. Together, these results indicate that β2M serum levels may serve as a new indicator for assessment of pulmonary diffusion function and pulmonary fibrosis severity in clinical practice and may provide a potential target for treatment of pulmonary fibrosis in the future.
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  • 文章类型: Journal Article
    在海平面游泳运动会导致一氧化碳(DLCO)的肺弥散能力短暂降低。暴露于低压缺氧会影响肺气体交换,缺氧性肺血管收缩可引起肺水肿。这项研究的目的是评估精英游泳运动员在14天的高原训练营(1850m)中DLCO是否发生变化,以及在中度缺氧中游泳和44分钟循环的联合训练的急性影响急性常压重度缺氧(3000m)。参与者是八名国际水平游泳运动员(5名女性和3名男性;17-24岁;173.5±5.5厘米;64.4±5.3公斤),每周训练量为80公里。单呼吸法用于测量DLCO和功能性气体交换参数的变化。在1850m进行14天的高原训练营后,未检测到DLCO的变化,但肺泡体积减少(VA;7.13±1.61vs.6.50±1.59L;p=0.005;d=0.396)和肺对一氧化碳的转移系数增加(KCO;6.23±1.03vs.在高原营地后观察到6.83±1.31mL·min-1·mmHg-1·L-1;p=0.038;d=0.509)。在急性缺氧联合治疗期间,在1850米游泳训练后,DLCO没有变化,但在模拟海拔3000米骑自行车后,DLCO有所下降(40.6±10.8vs.36.8±11.2mL·min-1·mmHg-1;p=0.044;d=0.341)。在中等海拔的训练营不会改变精英游泳运动员的肺弥散能力,尽管在较高的模拟海拔高度进行自行车运动会导致肺泡-毛细管气体交换受到一定程度的损害。
    Swimming exercise at sea level causes a transient decrease in lung diffusing capacity for carbon monoxide (DLCO). The exposure to hypobaric hypoxia can affect lung gas exchange, and hypoxic pulmonary vasoconstriction may elicit pulmonary oedema. The purpose of this study is to evaluate whether there are changes in DLCO during a 14-day altitude training camp (1850 m) in elite swimmers and the acute effects of a combined training session of swimming in moderate hypoxia and 44-min cycling in acute normobaric severe hypoxia (3000 m). Participants were eight international level swimmers (5 females and 3 males; 17-24 years old; 173.5 ± 5.5 cm; 64.4 ± 5.3 kg) with a training volume of 80 km per week. The single-breath method was used to measure the changes in DLCO and functional gas exchange parameters. No changes in DLCO after a 14-day altitude training camp at 1850 m were detected but a decrease in alveolar volume (VA; 7.13 ± 1.61 vs. 6.50 ± 1.59 L; p = 0.005; d = 0.396) and an increase in the transfer coefficient of the lung for carbon monoxide (KCO; 6.23 ± 1.03 vs. 6.83 ± 1.31 mL·min-1·mmHg-1·L-1; p = 0.038; d = 0.509) after the altitude camp were observed. During the acute hypoxia combined session, there were no changes in DLCO after swimming training at 1850 m, but there was a decrease in DLCO after cycling at a simulated altitude of 3000 m (40.6 ± 10.8 vs. 36.8 ± 11.2 mL·min-1·mmHg-1; p = 0.044; d = 0.341). A training camp at moderate altitude did not alter pulmonary diffusing capacity in elite swimmers, although a cycling session at a higher simulated altitude caused a certain degree of impairment of the alveolar-capillary gas exchange.
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