A non-invasive simplified scoring system to predict airway mucus plugs in asthma.
完整摘要 · 中文译文
背景：气道黏液栓是重症哮喘的核心病理特征，与气流受限及不良预后密切相关。然而，目前缺乏用于识别哮喘气道黏液栓的快速、高效临床筛查工具。 目的：本研究旨在开发并评价基于荟萃分析加权的评分，用于评估成人哮喘患者气道黏液栓的存在及严重程度。 方法：对六大主要数据库（截至2025年2月）进行系统综述和荟萃分析，以确定黏液栓的显著危险因素。随后，基于转换后的标准化效应量权重（β）构建了基于数学方程的评分和简化评分系统。然后使用华中科技大学同济医院105例哮喘患者队列（2024～2026年）对评分系统进行内部验证。 结果：该荟萃分析纳入10项研究（837例患者），确定年龄、肺功能参数（FEV1%、FVC%、FEV1/FVC%）及2型炎症标志物（FeNO、血嗜酸性粒细胞计数、IgE）为关键相关因素。在内部验证队列中，简化评分系统评估黏液栓存在的AUC为0.864（95% CI：0.785-0.943），特异度为0.941，敏感度为0.718。在评估较高黏液栓负荷方面，AUC为0.859（95% CI：0.777-0.941），敏感度为0.917，特异度为0.684。 结论：基于荟萃分析加权的评分显示出有前景的初步区分能力 用于评估黏液栓存在及更高负担。这些评分可能有助于确定患者进行高分辨率计算机断层扫描（HRCT）的优先顺序，但仍需外部验证。
完整摘要 · 英文原文
BACKGROUND: Airway mucus plugs are a core pathological feature of severe asthma and are closely associated with airflow limitation and poor prognosis. However, rapid and efficient clinical screening tools for identifying airway mucus plugs in asthma are currently lacking. OBJECTIVE: This study aimed to develop and evaluate meta‑analysis‑weighted scores for estimating the presence and severity of airway mucus plugs in adults with asthma. METHODS: A systematic review and meta-analysis of six major databases (up to February 2025) were conducted to identify significant risk factors for mucus plugs. Subsequently, a mathematical equation-based score and a simplified scoring system were constructed based on the converted standardized effect-size weights (β). Internal validation of the scoring system was then performed using a cohort of 105 asthma patients from Tongji Hospital, Huazhong University of Science and Technology (2024∼2026). RESULTS: The meta-analysis included 10 studies (837 patients) and identified age, pulmonary function parameters (FEV1%, FVC%, FEV1/FVC%), and type 2 inflammatory markers (FeNO, blood eosinophil count, IgE) as key associated factors. In the internal validation cohort, the simplified scoring system showed an AUC of 0.864 (95% CI: 0.785-0.943) for estimating mucus plug presence, with a specificity of 0.941 and sensitivity of 0.718. For estimating higher mucus plug burden, the AUC was 0.859 (95% CI: 0.777-0.941), with a sensitivity of 0.917 and specificity of 0.684. CONCLUSION: The meta-analysis-weighted scores showed promising preliminary discrimination for mucus plug presence and higher burden. These scores may assist in prioritizing patients for HRCT, though external validation is required.
摘要 待译
BACKGROUND: Airway mucus plugs are a core pathological feature of severe asthma and are closely associated with airflow limitation and poor prognosis. However, rapid and efficient clinical screening tools for identifying airway mucus plugs in asthma are currently lacking. OBJECTIVE: This study aimed to develop and evaluate meta‑analysis‑weighted scores for estimating the presence and severity of airway mucus plugs in adults with asthma.…