Lung diffusing capacity for nitric oxide and carbon monoxide in relation to morphological changes as assessed by computed tomography in patients with cystic fibrosis

被引：20
作者：
Dressel H. [1 ]
Filser L. [1 ]
Fischer R. [2 ]
Marten K. [3 ]
Müller-Lisse U. [4 ]
de la Motte D. [1 ]
Nowak D. [1 ]
Huber R.M. [2 ]
Jörres R.A. [1 ]
机构：
[1] Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, D-80336 München
[2] Department of Pneumology, Medizinische Klinik Innenstadt, Ludwig-Maximilians-University, D-80336 München
[3] Department of Diagnostic Radiology, University of Göttingen, Göttingen
[4] Institute for Clinical Radiology, Medizinische Klinik Innenstadt, Ludwig-Maximilians-University, D-80336 München
来源：
BMC Pulmonary Medicine | / 9卷 / 1期
关键词：
Cystic Fibrosis; Cystic Fibrosis Patient; Bronchiectasis; Alveolar Volume; Compute Tomography Score;
D O I：
10.1186/1471-2466-9-30
中图分类号：
学科分类号：
摘要：
Background: Due to large-scale destruction, changes in membrane diffusion (Dm) may occur in cystic fibrosis (CF), in correspondence to alterations observed by computed tomography (CT). Dm can be easily quantified via the diffusing capacity for nitric oxide (DLNO), as opposed to the conventional diffusing capacity for carbon monoxide (DLCO). We thus studied the relationship between DLNO as well as DLCO and a CF-specific CT score in patients with stable CF. Methods: Simultaneous single-breath determinations of DLNO and DLCO were performed in 21 CF patients (mean ± SD age 35 ± 9 y, FEV1 66 ± 28%pred). Patients also underwent spirometry and bodyplethysmography. CT scans were evaluated via the Brody score and rank correlations (rS) with z-scores of functional measures were computed. Results: CT scores correlated best with DLNO (rS = -0.83; p < 0.001). Scores were also related to the volume-specific NO transfer coefficient (KNO; rS = -0.63; p < 0.01) and to DLCO (rS = -0.79; p < 0.001) but not KCO. Z-scores for DLNO were significantly lower than for DLCO (p < 0.001). Correlations with spirometric (e.g., FEV1, IVC) or bodyplethysmographic (e.g., SRaw, RV/TLC) indices were weaker than for DLNO or DLCO but most of them were also significant (p < 0.05 each). Conclusion: In this cross sectional study in patients with CF, DLNO and DLCO reflected CT-morphological alterations of the lung better than other measures. Thus the combined diffusing capacity for NO and CO may play a future role for the non-invasive, functional assessment of structural alterations of the lung in CF. © 2009 Dressel et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 25 条
  • [1] Keens T.G., Mansell A., Krastins I.R., Levison H., Bryan A.C., Hyland R.H., Zamel N., Evaluation of the single-breath diffusing capacity in asthma and cystic fibrosis, Chest, 76, 1, pp. 41-44, (1979)
  • [2] Russell N.J., Bagg L.R., Hughes D.T., Neville E., Lung function in young adults with cystic fibrosis, Br J Dis Chest, 76, 1, pp. 35-43, (1982)
  • [3] Espiritu J.D., Ruppel G., Shrestha Y., Kleinhenz M.E., The diffusing capacity in adult cystic fibrosis, Respir Med, 97, 6, pp. 606-611, (2003)
  • [4] Merkus P.J., Govaere E.S., Hop W.H., Stam H., Tiddens H.A., de Jongste J.C., Preserved diffusion capacity in children with cystic fibrosis, Pediatr Pulmonol, 37, 1, pp. 56-60, (2004)
  • [5] Chemery L., Fekete K., Guillot S., Roussey M., Desrues B., Dabadie A., Belleguic C., Deneuville E., Dassonville J., Diffusing capacity for carbon monoxide (T(LCO)) and oxygen saturation during exercise in patients with cystic fibrosis, Arch Pediatr, 11, 9, pp. 1060-1066, (2004)
  • [6] de Jong P.A., Lindblad A., Rubin L., Hop W.C., de Jongste J.C., Brink M., Tiddens H.A., Progression of lung disease on computed tomography and pulmonary function tests in children and adults with cystic fibrosis, Thorax, 61, 1, pp. 80-85, (2006)
  • [7] Borland C.D., Higenbottam T.W., A simultaneous single breath measurement of pulmonary diffusing capacity with nitric oxide and carbon monoxide, Eur Respir J, 2, 1, pp. 56-63, (1989)
  • [8] MacIntyre N., Crapo R.O., Viegi G., Johnson D.C., Grinten C.P.M., Brusasco V., Burgos F., Casaburi R., Coates A., Enright P., Gustafsson P., Hankinson J., Jensen R., McKay R., Miller M.R., Navajas D., Pedersen O.F., Pellegrino R., Wanger J., Standardisation of the single-breath determination of carbon monoxide uptake in the lung, Eur Respir J, 26, 4, pp. 720-735, (2005)
  • [9] Guenard H., Varene N., Vaida P., Determination of lung capillary blood volume and membrane diffusing capacity in man by the measurements of NO and CO transfer, Respir Physiol, 70, pp. 113-120, (1987)
  • [10] Rosenfeld M., An overview of endpoints for cystic fibrosis clinical trials: One size does not fit all, Proc Am Thorac Soc, 4, 4, pp. 299-301, (2007)
123