Quais os parâmetros funcionais que permitem diferenciar asma grave de DPOC?

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"tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "253" "paginaFinal" => "272" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ricardo Marques Dias, Fernando Hauaji Chacur, Sonia Regina da Silva Carvalho, Denise Duprat Neves" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ricardo Marques" "apellidos" => "Dias" "email" => array:1 [ 0 => "dias.ricardomarques@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] 1 => array:3 [ "nombre" => "Fernando Hauaji" "apellidos" => "Chacur" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "2" "identificador" => "af0010" ] ] ] 2 => array:3 [ "nombre" => "Sonia Regina" "apellidos" => "da Silva Carvalho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "3" "identificador" => "af0015" ] ] ] 3 => array:3 [ "nombre" => "Denise Duprat" "apellidos" => "Neves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "4" "identificador" => "af0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Prof. Titular da Disciplina Cardiopulmonar da UNIRIO/Full Professor, Cardiopulmonary Sciences, UNIRIO" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Médico Responsável pelo Serviço de Provas de Função Respiratória do Pró-Cardíaco/Head Physician, Respiratory Function Test Unit, Hospital Pró-Cardíaco" "etiqueta" => "2" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Prof.ª Adjunta da Disciplina Cardiopulmonar da UNIRIO/Assistant Professor, Cardiopulmonary Sciences, UNIRIO" "etiqueta" => "3" "identificador" => "af0015" ] 3 => array:3 [ "entidad" => "Prof.ª Associada da Disciplina Cardiopulmonar da UNIRIO/Assistant Professor, Cardiopulmonary Sciences, UNIRIO" "etiqueta" => "4" "identificador" => "af0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "Correspondência/Correspondence to: Ricardo Marques Dias, Rua Barão da Torre 388/104, Rio de Janeiro – Brasil – 22411000," ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Which functional parameters can help differentiate severe asthma from COPD?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-07-14" "fechaAceptado" => "2009-08-06" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570125" "palabras" => array:3 [ 0 => "Testes de função pulmonar" 1 => "asma" 2 => "DPOC" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570124" "palabras" => array:3 [ 0 => "Lung function test" 1 => "asthma" 2 => "COPD" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "Com o objectivo de identificar parâmetros funcionais respiratórios que contribuam para o diagnóstico diferencial entre asma e DPOC, estudámos 20 asmáticos e 30 bronquíticos, com ou sem enfisema, com os exames usuais de função pulmonar: espirografia, pletismografia e DLCO, pré e pós-broncodilatação para os dois primeiros exames. Os grupos apresentam diferenças significativas na sua constituição. Os asmáticos são mais jovens, média de 48 anos, contra 59 anos no grupo com DPOC, e o grupo é constituído predominantemente por mulheres, 65% contra 40%, respectivamente. Os exames funcionais pulmonares, realizados conforme as directrizes internacionais, mostram, pela espirografia, que os asmáticos têm obstrução mais intensa, VEF1/CVF de 59 versus 66 e maior resposta broncodilatadora pelo VEF1, quer em valor absoluto, quer por variação percentual, do basal (%) ou do valor previsto (%P). A DLCO mostra-se, em média, normal entre os asmáticos, 103%P, e diminuída no grupo com DPOC, 69%P. Na pletismografia constatámos que os asmáticos têm maior volume residual (%P) e resistência de vias aéreas. Concluímos que vários parâmetros funcionais diferenciam a asma da DPOC, como um grupo; na análise individual, a DLCO é o parâmetro que melhor discrimina as duas doenças, possuindo maior especificidade para o diagnóstico de DPOC, seguida pelas variações de VEF1na broncodilatação, com maior sensibilidade para o diagnóstico de asma. Desta forma, estes dois exames são destaque no diagnóstico diferencial das doenças obstrutivas.Rev Port Pneumol 2010; XVI (2): 253-272" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "The aim of this study was to identify the respiratory function parameters that help in the accurate diagnosis of asthma and COPD. We studied 20 asthma and 30 COPD patients who underwent lung function tests including spirometry and plethysmography both with bronchodilator test and diffusion with carbon monoxide (DLCO). The tests were performed according to International Guidelines (ATS/ERS). The asthma patients were younger (mean age=48) than those in the COPD group (mean age=59) and this group also had more female patients (65%) than the COPD group (40%). The results showed a more severe obstruction in the asthma group: FEV1/FVC=59% versus 66% for COPD. There was also a greater bronchodilator response as shown by changes in absolute and percentage values for FEV1 in the asthma group. Average DLCO values were normal in the asthma group (103%P) and lower in the COPD (69%). In plethysmography the asthma group had a higher residual volume (%P) and a higher airway resistance. We concluded that many functional parameters were useful in distinguishing the asthma and COPD groups. In individual analysis, DLCO was the parameter which best aided in an accurate diagnosis in both groups, with a higher specificity for COPD. The bronchodilator response measured by changes in FEV1 showed a higher sensitivity for asthma. Thus, these two tests are highlighted in the differential diagnosis of obstructive diseases.Rev Port Pneumol 2010; XVI (2): 253-272" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "Bibliografia/Bibliography" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Distinguishing among asthma, chronic bronchitis, and emphysema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.L. 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