第一秒用力呼气容积与第六秒用力呼气容积比值及第六秒用力呼气容积在阻塞及限制性肺通气功能障碍中诊断价值的研究  

The value of forced expiratory volume in 1 second/forced expiratory volume in 6 second and forced expiratory volume in 6 second in diagnosis of obstructive and restrictive lung ventilation dysfunction

作　　者：仲昭双[1] 王冉[1] 夏书月[1] 

机构地区：[1]沈阳医学院附属中心医院呼吸内科,110001

出　　处：《中国医师进修杂志》2014年第34期45-47,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨应用第6秒用力呼气容积（FEV6）替代用力肺活量（rvc）用于阻塞性及限制性肺通气功能障碍的诊断。方法对470例行肺功能检查的门诊患者进行回顾性分析，分别以第1秒用力呼气容积（FEV6）／FVC〈70％及FEV，／FVC正常而FVC占预计值百分比〈80％为标准，绘制受试者工作特征曲线，以灵敏度与特异度之和最大为标准，分别确定FEV1／FEV6及FEV6占预计值百分比的最佳诊断界值及灵敏度与特异度。采用交叉列联表方法计算准确率，采用Kappa检验判定一致性。结果以FEV。／FVC〈70％为金标准，FEV1／FEV6诊断阻塞性及限制性肺通气功能障碍的最佳诊断界值为71％，灵敏度为97．5％（154／158），特异度为98．7％（308／312），准确率为98．3％（462／470），Kappa=0．962（P=0．000）；以FEV1／FVC正常而FVC占预计值百分比〈80％为金标准，FEV。占预计值百分比诊断限制性肺通气功能障碍的最佳诊断界值为82％，灵敏度为96．1％（73，76），特异度为95．7％（222／232），准确率为95．8％（295／308），Kappa=0．890（P=0．000）。结论FEV6可以有效替代FVC用于阻塞性及限制性肺通气功能障碍的诊断，FEV1／FEV6诊断阻塞性及限制性肺通气功能障碍的最佳诊断界值为71％，FEV6占预计值百分比诊断限制性肺通气功能障碍的最佳诊断界值为82％。Objective To determine the value of forced expiratory volume in 6 second （FEV6） and forced expiratory volume in 1 second （FEV,）/FEV6 in diagnosis of obstructive and restrictive lung ventilation dysfunction. Methods A total of 470 cases receiving spirometric examinations were analyzed retrospectively. A subject was considered to have obstruction if FEV1/forced vital capacity （FVC） was 〈 70%. The restriction was defined as FVC 〈 80% in the absence of obstruction. The best cut-off of FEVJFEV6 and FEV6 were determined through receiver-operating characteristics curve, and the sensitivity, specificity, accuracy and Kappa of FEVJFEV6 and FEV6 were calculated. Results It showed that the current cut-off points used to detect obstructi6n and restriction could be replaced by FEV1/FEVs was 71% and FEV6 was 82%, respectively. FEV1/FEV6 had sensitivity of 97.5% （154/158）, specificity of 98.7% （308/312）, accuracy of 98.3% （462/470） and Kappa of 0.962 （P = 0.000）. For restrictive pattern, FEV6 had sensitivity of 96.1% （73/76）, specificity of 95.7% （222/232）, accuracy of 95.8% （295/308） and Kappa of 0.890 （P =0.000）.Conclusions FEV6 can be a valid alternative for FVC in the diagnosis of obstructive and restrictive lung ventilation dysfunction.

关 键 词：呼吸功能试验 肺通气功能障碍 第6秒用力呼气容积 肺活量 

分 类 号：R563.9[医药卫生—呼吸系统]