Which functional parameters can help differentiate severe asthma from COPD?
Quais os parâmetros funcionais que permitem diferenciar asma grave de DPOC?
Ricardo Marques Dias1,5,
, Fernando Hauaji Chacur2,5, Sonia Regina da Silva Carvalho3,5, Denise Duprat Neves4,5
Corresponding author
dias.ricardomarques@gmail.com
Correspondence to/Correspondência: Dias Rua Barão da Torre 388/104, Rio de Janeiro – Brasil – 22411000.
Correspondence to/Correspondência: Dias Rua Barão da Torre 388/104, Rio de Janeiro – Brasil – 22411000.
1 Prof. Titular da Disciplina Cardiopulmonar da UNIRIO/Full Professor, Cardiopulmonary Sciences, UNIRIO
2 Médico Responsável pelo Serviço de Provas de Função Respiratória do Pró-Cardíaco/Head Physician, Respiratory Function Test Unit, Hospital Pró-Cardíaco
3 Prof.ª Adjunta da Disciplina Cardiopulmonar da UNIRIO/Assistant Professor, Cardiopulmonary Sciences, UNIRIO
4 Prof.ª Associada da Disciplina Cardiopulmonar da UNIRIO/Assistant Professor, Cardiopulmonary Sciences, UNIRIO
5 Trabalho realizado no Hospital Pró-Cardíaco e no Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO)/Study undertaken at the Hospital Pró-Cardíaco and Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO)
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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" "apellidos" => "Marques Dias" "email" => array:1 [ 0 => "dias.ricardomarques@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">5</span>" "identificador" => "aff0025" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Fernando" "apellidos" => "Hauaji Chacur" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">5</span>" "identificador" => "aff0025" ] ] ] 2 => array:3 [ "nombre" => "Sonia Regina" "apellidos" => "da Silva Carvalho" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">5</span>" "identificador" => "aff0025" ] ] ] 3 => array:3 [ "nombre" => "Denise" "apellidos" => "Duprat Neves" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">5</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Prof. Titular da Disciplina Cardiopulmonar da UNIRIO/<span class="elsevierStyleItalic">Full Professor, Cardiopulmonary Sciences, UNIRIO</span>" "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Médico Responsável pelo Serviço de Provas de Função Respiratória do Pró-Cardíaco/<span class="elsevierStyleItalic">Head Physician, Respiratory Function Test Unit, Hospital Pró-Cardíaco</span>" "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Prof.ª Adjunta da Disciplina Cardiopulmonar da UNIRIO/<span class="elsevierStyleItalic">Assistant Professor, Cardiopulmonary Sciences, UNIRIO</span>" "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Prof.ª Associada da Disciplina Cardiopulmonar da UNIRIO/<span class="elsevierStyleItalic">Assistant Professor, Cardiopulmonary Sciences, UNIRIO</span>" "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Trabalho realizado no Hospital Pró-Cardíaco e no Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO)/<span class="elsevierStyleItalic">Study undertaken at the Hospital Pró-Cardíaco and Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO)</span>" "etiqueta" => "<span class="elsevierStyleSup">5</span>" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondence to/Correspondência: Dias Rua Barão da Torre 388/104, Rio de Janeiro – Brasil – 22411000." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Quais os parâmetros funcionais que permitem diferenciar asma grave de DPOC?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-07-14" "fechaAceptado" => "2009-08-06" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec160686" "palabras" => array:3 [ 0 => "Lung function test" 1 => "asthma" 2 => "COPD" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec160685" "palabras" => array:3 [ 0 => "Testes de função pulmonar" 1 => "asma" 2 => "DPOC" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">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<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>48) than those in the COPD group (mean age<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>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<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>59% <span class="elsevierStyleItalic">versus</span> 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.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">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 <span class="elsevierStyleItalic">versus</span> 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 VEF1 na broncodilatação, com maior sensibilidade para o diagnóstico de asma. Desta forma, estes dois exames são destaque no diagnóstico diferencial das doenças obstrutivas.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography/Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "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. Snider" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "1985" "volumen" => "87" "numero" => "Suppl 1" "paginaInicial" => "35S" "paginaFinal" => "39S" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3964740" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| Year/Month | Html | Total | |
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| 2024 November | 3 | 2 | 5 |
| 2024 October | 23 | 32 | 55 |
| 2024 September | 24 | 24 | 48 |
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