支气管反应活性指数在气道高反应者哮喘的诊断价值  

Value of Bronchial Reactivity Index to Diagnosis of Bronchial Asthma in Patients with Airway Hyperresponsiveness

作　　者：方年新[1,2] 黄俊伟[1,2] 何小兵[1,2] 陈正贤[1,2] 

机构地区：[1]广东省人民医院呼吸内科 [2]广东省医学科学院,广东广州510080

出　　处：《中山大学学报（医学科学版）》2010年第3期428-431,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2007B031507006)

摘　　要：【目的】探讨支气管反应活性指数(BRI)对支气管哮喘的诊断价值。【方法】对101例支气管激发试验阳性患者随访两年,4例失访,其中56例临床确诊为支气管哮喘,为哮喘组;41例未诊断哮喘的患者为非哮喘组。计算BRI,采用Logistic回归分析BRI与哮喘诊断之间的关系,以ROC曲线评价BRI在诊断哮喘中的敏感性和特异性。【结果】BRI哮喘组1.37±0.17,非哮喘组1.19±0.11(P<0.05);Logistic回归分析BRI是支气管哮喘诊断中唯一的预测变量;ROC曲线下面积为81.6%,BRI最佳截点为1.30,敏感度为69.6%,特异度为85.4%。【结论】支气管激发试验阳性联合BRI可提高支气管哮喘诊断的特异度。【Objective】To investigate the diagnostic value of bronchial reactivity index（BRI）to bronchial asthma.【Methods】 A total of 101 cases with positive bronchial provocation test have been enrolled into our study.Two years following up,4 patients were lost,the remaining 97 patients were divided into two groups（asthma group and non-asthmatic group）according to clinical diagnose criterion;asthma group had 56 cases and non-asthmatic group 41 cases.All BRI were calculated,logistic regression was applied to assess the interaction between BRI and asthma,the sensitivity and specificity of BRI in the diagnosis of asthma were assessed according to ROC curve.【Results】BRI for asthma group and non-asthmatic group were 1.37±0.17 and 1.19±0.11,respectively（P0.05）.By logistic regression,BRI was the only independent variable identified as a predictor in the diagnosis of bronchial asthma.Area beneath the ROC curve was 81.6%.The optimal cut-off of BRI differentiate asthmatic and non-asthmatic subjects,which was bigger than or equal to 1.30,was selected according to the ROC curve.This point reached 69.6%sensitivity and 85.4%specificity in the diagnosis of bronchial asthma.【Conclusion】The diagnosis of bronchial asthma specificity can be improved greatly association positive bronchial provocation test with BRI.

关 键 词：支气管反应活性指数 哮喘 气道高反应性 支气管激发试验 

分 类 号：R562.5[医药卫生—呼吸系统]