Study of respiratory function of the lungs in smokers and patients with chronic obstructive pulmonary disease
https://doi.org/10.30629/0023-2149-2024-102-3-241-246
Abstract
The article discusses the use of methods for assessing lung respiratory function in patients with chronic obstructive pulmonary disease (COPD) and smokers.
The aim of the study is a comparative evaluation of the informative value of capnometry, spirometry, multiple breath nitrogen washout method, and diffusion test in patients with COPD, as well as an early detection of respiratory function impairment in smokers.
Results. Three groups of patients were examined: 1st — 30 patients with moderately severe COPD, average age 50.6 ± 4.3 years, 2nd — 30 smokers, average age 45.6 ± 2.4 years, 3rd (control group) — 30 practically healthy non-smokers, average age 45.6 ± 2.4 years. Capnometry showed a statistically significant increase in the slope of the alveolar phase in patients with COPD compared to the control group and smokers at rest, both before and after bronchodilator use. Significant differences between smokers and control groups were detected during forced exhalation. According to spirometry data, the FEV1/FVC ratio in patients with COPD was statistically significantly lower compared to the control group and smokers, both before and after bronchodilator use. Diffusion capacity was significantly lower in patients with COPD and smokers compared to the control group. The lung clearance index was significantly higher in the COPD group compared to the other two groups.
Conclusions. All the mentioned methods were informative in patients with COPD, but capnometry and lung diffusion capacity assessment were sensitive methods in smokers, revealing uneven distribution of ventilation-perfusion ratios in the lungs and impaired gas exchange function.
About the Authors
A. I. MikhailovichevaRussian Federation
Anna I. Mikhailovicheva — specialist of functional diagnostics depart- ment of Department of Functional and Ultrasound Diagnostics Academy of Postgraduate Education under Federal Scientific Clinical Center for Specialized Types of Medical Care and Medical Technology FMBA of Russia
Moscow
V. V. Smirnov
Russian Federation
Vladimir V. Smirnov — Dr of Sci. (Med.), Professor, Head of the Depart- ment of Therapy of the Academy of Postgraduate Education Academy of Postgraduate Education under Federal Scientific Clinical Center for Specialized Types of Medical Care and Medical Technology FMBA of Russia
Moscow
P. V. Struchkov
Russian Federation
Pyotr V. Struchkov — Dr of Sci. (Med.), Professor, Head of the Depart- ment of Clinical Physiology and Functional Diagnostics of the Academy of Postgraduate Education under Federal Scientific Clinical Center for Specialized Types of Medical Care and Medical Technology FMBA of Russia, Deputy Head of Diagnostic Departament Clinical Hospital No.85 of FMBA of Russia
Moscow
N. S. Nosenko
Russian Federation
Natalia S. Nosenko — Cand. of Sci. (Med.), Head of the Department of Functional and Ultrasound Diagnostics Federal Scientific Clinical Center for Specialized Types of Medical Care and Medical Technology FMBA of Russia, Associate Professor of the Department of Radiology and Ultrasound Diagnostics Academy of Postgraduate Education under Federal Scientific Clinical Center for Specialized Types of Medical Care and Medical Technology FMBA of Russia
Moscow
A. G. Sotnikova
Russian Federation
Anna G. Sotnikova — Cand. of Sci. (Med.), Head of Pulmonology Department
Moscow
E. O. Dyachkova
Russian Federation
Elizaveta O. Dyachkova — pulmonologist
Moscow
T. I. Divakova
Russian Federation
Tatiana I. Divakova — pulmonologist
Moscow
Yu. A. Bazhenova-Bessonova
Russian Federation
Yulia A. Bazhenova-Bessonova — Head of the department of functional diagnostics
Moscow
I. A. Manichev
Belarus
Igor A. Manichev — Cand. of Sci. (Fiz.-Mat.), Head
Minsk
References
1. Hanlon P., Guo X., McGhee E., Lewsey J., McAllister D., Mair F.S. Systematic review and meta-analysis of prevalence, trajectories, and clinical outcomes for frailty in COPD. NPJ Prim. Care Respir. Med. 2023;33(1):1. DOI: 10.1038/s41533-022-00324-5
2. Yang I.A., Jenkins Ch.R., Salvi S.S. Obstructive pulmonary disease in never-smokers: risk factors, pathogenesis, and implications for prevention and treatment. Lancet Respir. Med. 2022;10(5):497 –511. PMID: 35427530 DOI: 10.1016/S2213-2600(21)00506-3
3. Lamprecht B., McBurnie M.A., Vollmer W.M. et al. BOLD Collaborative Research Group: COPD in never smokers: results form the population-based burden of obstructive lung disease study. Chest. 2011;139:752–763.
4. Struchkov P.V. Capnometry. The book: Pulmonary function tests from theory to practice. Edited by O.I. Savushkina and A.V. Chernyak, M., LLC "Firm Strom", 2017:181–186. (In Russian).
5. Nekludova G.V., Chernyak A.V. Diagnostic features of the measuring the lung diffusion capacity. Medical alphabet. 2020;(25):22–25. (In Russian). DOI: 10.33667/2078-5631-2020-25-22-25
6. Graham B.L., Brusasco V., Burgos F., Cooper B.G., Jensen R., Kendrick A., MacIntyre N.R., Thompson B.R., Wanger J. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur. Respir. J. 2017;49(1):1600016. DOI: 10.1183/13993003.00016-2016
7. Kameneva M.Yu., Chernyak A.V., Aisanov Z.R., Avdeev S.N., Babak S.L., Belevskiy А.S. et al. Spirometry: national guidelines for the testing and interpretation of results. Pulmonology. 2023;33(3):07–340. (In Russian). DOI: 10.18093/08690189-2023-33-3-307-340
8. Robinson P.D., Latzin Ph., Verbanck S., Hall G.L., Horsley A., Gappa M. et al. Consensus statement for inert gas washout measurement using multiple- and single-breath tests. The European Respiratory Journal. 2013;41(3):507–22.
9. Stanojevic S., Kaminsky D.A., Miller M., Thompson B., Aliverti A., Barjaktarevic I. et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur. Respir. J. 2022;60(1):2101499. DOI: 10.1183/13993003.01499-2021
10. Savushkina O.I., Cherniak A.V. Methods for diagnosing dysfunction of small airways and uniformity of lung ventilation: their use after a novel coronavirus infection. Bulletin Physiology and Pathology of Respiration. 2022;1(84):137–143. (In Russian). DOI: 10.36604/1998-5029-2022-84-137-143
11. Neklyudova G.V., Chernyak A.V. Method of nitrogen leaching during multiple respirations in healthy people. Practical Pulmonology. 2019;4. (In Russian).
12. Quanjer P.H., Tammeling G.J., Cotes J.E., Pedersen O.F., Peslin R., Yernault J.C. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. The European Respiratory Journal. Supplement. 1993;16:5–40.
Review
For citations:
Mikhailovicheva A.I., Smirnov V.V., Struchkov P.V., Nosenko N.S., Sotnikova A.G., Dyachkova E.O., Divakova T.I., Bazhenova-Bessonova Yu.A., Manichev I.A. Study of respiratory function of the lungs in smokers and patients with chronic obstructive pulmonary disease. Clinical Medicine (Russian Journal). 2024;102(3):241-246. (In Russ.) https://doi.org/10.30629/0023-2149-2024-102-3-241-246