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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2022.tde-20062022-153427
Document
Author
Full name
Jéssica Perossi Nascimento
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2021
Supervisor
Committee
Gastaldi, Ada Clarice (President)
Matte, Darlan Lauricio
Menezes, Marcelo Bezerra de
Title in Portuguese
Correlação entre índices clínicos, funcionais e morfológicos do sistema respiratório em pacientes com bronquiectasias não decorrentes de fibrose cística
Keywords in Portuguese
Bronquiectasia
Função pulmonar
Oscilometria
Tomografia
Abstract in Portuguese
Introdução: O diagnóstico de bronquiectasias é baseado nos achados clínicos, tomografia computadorizada e nos resultados de testes de função pulmonar como avaliação complementar. Diferente da espirometria, o Sistema de Osciometria de Impulso (IOS) detecta alterações precoces no sistema respiratório, além de fornecer uma análise compartimentada das vias aéreas. Objetivo: Correlacionar índices clínicos, funcionais e morfológicos em pacientes com bronquiectasias não-decorrentes de fibrose cística (BNFC). Metodologia: 38 pacientes com BNFC, clinicamente estáveis, entre 19 e 76 anos, foram submetidos a avaliações clínicas (antropometria, escala Medical Research Council - MRC e Bronchiectasis Severity Index - BSI), funcionais (espirometria e IOS) e morfológicas (tomografia computadorizada de alta resolução - TCAR de tórax, analisada por escore subjetivo TCAR e por análise quantitativa automática). Resultados: As melhores correlações obtidas entre os índices funcionais e morfológicos do sistema respiratório foram: R5 e medida normalizada da espessura da parede brônquica para uma via aérea com perímetro interno de 10mm (Pi10) (r=0,57) e FEF25-75% e escore TCAR (r=-0,39). O BSI, assim como o MRC, apresentaram correlações melhores com a análise quantitativa automática da TCAR (BSI e Pi10: r=0,41; MRC e Pi10: r=0,35) do que com o escore subjetivo (BSI e escore TCAR: r=0,41; MRC e escore TCAR: r=0,15) e, correlações fracas e moderadas foram obtidas com ambos os índices funcionais do sistema respiratório (BSI e R5-R20: r=0,53; BSI e VEF1: R=-0,64; MRC e R5-R20: r= 0,42; MRC e VEF1: r=-0,45). Conclusão: Em pacientes com BNFC, métodos compartimentados de avaliação do sistema respiratório (IOS e análise quantitativa automática da TCAR) correlacionam-se melhor entre si quando comparados com métodos globais (espirometria e escore subjetivo da TCAR).
Title in English
Correlation among clinical, functional and morphological indexes of the respiratory system in non-cystic fibrosis bronchiectasis patients
Keywords in English
Bronchiectasis
Oscillometry
Pulmonary function
Tomography
Abstract in English
Background: Bronchiectasis diagnosis is based on clinical findings, high-resolution computed tomography and by pulmonary function tests (PFT) as a complementary evaluation. When compared to spirometry, Impulse Oscillometry System (IOS) detects early changes in respiratory system both in central and peripheral airways. Objective: To correlate clinical, function and morphological indexes in patients with non-cystic fibrosis bronchiectasis (NCFB). Metodology: 38 clinically stable NCFB patients, between 19 and 76 years old, were submitted to clinical (anthropometric measurements, MRC scale and bronchiectasis severity index - BSI), functional (spirometry and impulse oscillometry system - IOS) and morphological (computed tomography analysed by a subjective score and an automated quantitative analysis) evaluations. Results: The bests correlations obtained between functional and morphological airway indexes were: R5 and Pi10 (r=0.57), and FEF25-75% and CT score (r=-0.39). BSI as well as MRC showed bests correlations with the quantitative automated analysis of CT (BSI and Pi10: r-0.41; MRC and Pi10: r=0.35) than with subjective CT score (BSI and CT score: r=0.41; MRC and CT score: r=0.15); and moderated and weak correlations were obtained on both functional airways indexes (BSI and R5-R20: r=0.53; BSI and FEV1: r=-0.64; MRC and R5-R20: r=0.42; and MRC and FEV1: r=-0.45). Conclusion: In NCFB patients, compartmental methods of respiratory system analysis (IOS and automated quantitative CT analysis) correlated better between itself than when compared with global methods (spirometry and subjective CT score).
 
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Publishing Date
2022-06-21
 
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