Oscilações forçadas e modelamento fracional no diagnóstico precoce dos efeitos do tabagismo e da doença pulmonar obstrutiva crônica

• Autor(a) principal: Ribeiro, Caroline de Oliveira
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/12711
• topic: Chronic Obstructive Pulmonary Disease; Forced Oscillations Technique; Early diagnosis; Doença Pulmonar Obstrutiva Crônica; Técnica de Oscilações Forçadas; Diagnóstico Precoce; Doença pulmonar obstrutiva crônica; Tabagismo; Pulmões Doenças; Diagnóstico Precoce; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

Chronic obstructive pulmonary disease (COPD) is defined as a chronic respiratory condition that is characterized by a persistent progressive limitation of airflow associated with an inflammatory response in the airways and lung responsive to noxious particles or gases. The chronic airflow limitation characteristic of COPD is caused by a combination of airway and pulmonary parenchymal irregularities, with the main factors being the sum of chronic bronchitis, where inflammation of the large and small airways predominates; and of emphysema, whose main histopathological characteristic is the increase of the aerial spaces and destruction of the parenchymatous tissue. Airway obstruction in COPD is associated with progressive increase in airflow limitation, which is usually diagnosed through spirometry. It has been previously observed that spirometric indices are not sensitive to minor changes due to smoking. The Forced Oscillation Technique (FOT) represents a complement to the conventional pulmonary function test, since it is more sensitive in the detection of obstruction in the peripheral airways. The extended RIC model (eRIC) is suggested as a model that has improvements compared to the RIC model. The fractional order models (FrOr) were recently proposed, allowing a more detailed and accurate description of the dynamic behavior of living systems. In this context the present work presented the following objectives: To improve our knowledge about the pathophysiology of smoking and COPD; To evaluate the FOT potential associated to fractional order models in the early diagnosis of smoking effects; Carry out similar evaluations in patients with early- stage COPD; Determine the best parameters for the diagnoses cited. It is a controlled cross-sectional study. The patients were submitted to the pulmonary function test and FOT. In the control group (CG) 40 healthy subjects were included, in the smokers group 40 subjects and in the light COPD group 40. The parameters that stood out with very high values (AUC> 0.90) were L, Beta and N, in the mild COPD group, and Beta and N, in the Smoking group. These results demonstrate that FOT can be considered a promising methodology for the analysis of pulmonary function changes due to the disease.