支气管舒张试验判定指标的诊断价值  

Diagnostic value of various pulmonary function standards of bronchodilation test

作　　者：梅静静[1] 陈亚红[1] 王新茂[1] 梁岩静[1] 柳晓芳[1] 

机构地区：[1]北京大学第三医院呼吸科,100191

出　　处：《国际呼吸杂志》2014年第3期196-199,共4页International Journal of Respiration

摘　　要：目的研究相关肺功能指标在支气管舒张试验中的诊断价值。方法收集北京大学第三医院门诊肺功能室1044例患者的肺功能资料，以临床常用标准FEV，标准为参照，评估FVC，呼气峰流速（PEF），用力呼气流速25％-75％（FEF25％-75％）对支气管舒张试验的诊断价值。结果应用支气管舒张剂后，FEV。，FVC，PEF，FEF25％-75％的阳性率分别为26．7％，21．8％，21．8％，34．0％，以FEV，标准为参照，FVC，PEF，FEF25%-75％等三项标准的灵敏度分别为53．0％，49．5％，97．8％，特异度分别为89．5％，88．2％，83．8％，阳性预测值分别为64．9％，60．5％，68．8%，阴性预测值分别为83．9％，82．7％，99．1％，ROC曲线下面积分别为0．866，0．798，0．979，Kappa值分别为O．45，0．40，0．72。结论支气管舒张试验应以FEV。作为主要标准，并联合其他多项肺功能指标及临床资料加以综合评价。Objective To evaluate the diagnostic value of various pulmonary function standards of diagnosing on bronchodilation test. Methods The lung function test results of 1 044 patients in Peking university third hospital were collected, and compared with FEV~ criterion as reference, the diagnostic value of FVC,PEF and FEF25%-75 % on bronchodilation test were estimated. Results The positive rate of FEV~ ,FVC,PEF and FEF25%-75% were respectively 26.7%,21.8% ,21.8% and 34.0%. Jarging by FEV1 as objective reference, the sensitivity of FVC,PEF and FEF25%-75% were 53.0%, 49.5%and 97.8% respectively,the specificity of them were 89.5% ,88.2% and 83.8%,the positive predictive value of them were 64.9% ,60.5% ,68.8%,the negative predictive value of them were 83.9% ,82.7% ,99.1%, the area under the ROC curve of them were separately 0. 866,0. 798 and 0. 979 ,and the Kappa statistic o~ FVC,PEF and FEF25%-75% were 0.45,0.40 and 0.72 respectively. Conclusions FEV1 should be used as the primary standard in assessing bronchodilator reversibility, and other standards and clinical features are also important for evaluating the results of bronchodilatation test.

关 键 词：支气管舒张试验 肺功能指标 诊断价值 

分 类 号：R562.2[医药卫生—呼吸系统]