Application of impulse oscillometry and bronchial dilation test for analysis in patients with asthma and chronic obstructive pulmonary disease

Abstract

Impulse oscillometry (IOS) is a good method for measuring airway resistance. The aim of this study was to assess the diagnostic contribution of IOS combined with bronchial dilation test (BDT) when distinguishing between patients with asthma and those with chronic obstructive pulmonary disease (COPD). 870 were enrolled in the study including 561 patients with asthma, 100 patients with COPD and 209 patients with chronic coughing or normal subjects. All the participants underwent routine pulmonary function tests, IOS and BDT examination. And IOS examination was before and after BDT. IOS parameters (R5, R20, R25, R35, X5, X20, X25, X35, Fres, Zrs & RP) and forced expiratory volume in one second (FEV1) were recorded. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the diagnostic ability to differentiate asthma and COPD. The discriminative power of the various parameters studied was determined by means of ROC curves: the area under the curve (AUC), sensitivity and specificity. The X5, X20, X25, X35, Fres, Zrs and Rp correlated better with COPD. In particular, X5, Fres and X25 have been found to be significantly correlated with COPD. The diagnostic efficiency of X5, Fres and X25 when diagnosis COPD, expressed by ROC curve parameters, was as follows: AUC (0.725, 0.730, 0.724), sensitivity (67%, 77%, 83%) and specificity (68%, 65%, 58%), respectively. The diagnostic efficiency of Zrs, R5 and X35 when diagnosis asthma, expressed by ROC curve parameters, was as follows: AUC (0.721, 0.710, 0.695), sensitivity (62%, 72%, 53%) and specificity (72%, 61%, 76%), respectively. Our findings show, that X5, X25 and Fres may be useful for predictions and evaluations for COPD. And R5, X35 and Zrs may provide useful IOS parameters for asthma. IOS combined BDT could be useful diagnostic and differential diagnosis between asthma and COPD.