The Clinical Role of Changes of Maximum Expiratory Flow at 25%and 50%of Vital Capacity before and after Bronchodilator Reversibility Test in Diagnosing Asthma  

作　　者：Xu-xuc GUO Xiao-fan LIU Ai-ling WANG Qian-hui CHEN Shuo CHEN Ni-shan DENG Rui-yun LI Xu-hong DING Su ping HU Han-xiang NIE 

机构地区：[1]Department of Respiratory&Critical Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,China [2]Department of Pulmonary and Critical Care Medicine,The Central Hospial of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China [3]Nursing Department,Wuhan University School of Health Sciences,Wuhan 430071,China

出　　处：《Current Medical Science》2020年第4期677-682,共6页当代医学科学（英文）

基　　金：This project was supported by the National Natural Science Foundation of China(No.81970024);partly by Scientific Research Project of Wuhan Health Committee(No.WX16C45).

摘　　要：Summary:Changes of maximum expiratory flow at 25%and 50%of vital capacity(MEF2s and MEFso,respectively),and predominant parameters indicating small airways function in asthmatics before and after bronchodilator(BD)reversibility test have been less interpreted.Our study aimed to investigate the clinical role of changes of MEF2s and MEFso before and after BD reversibility test in diagnosing asthma.Forced expiratory volume in the first second(FEV),MEF2s,and MEFso were measured before and after BD reversibility test in 207 asthmatic patients using standard process.Forty healthy individuals were enrolled as controls.Receiver operating characteristic(ROC)curve was used to assess the diagnostic accuracy of reversibility of MEF2s and MEFgo before and after BD reversibility test(OMEF 2s%and AMEF so%,respectively)in diagnosing asthma.Among these functional criteria,AMEF2;%and 0MEFs%≥25%performed the best diagnostic performance.The sensitivity,specificity,and accuracy of AMEF 25%≥25%as an objcctive diagnostic test for asthma were 63.29%,87.50%,and 67.21%,and of AMEFs0%≥25%were 79.23%,85.00%,and 80.16%,respectively.The area under the ROC curve of the indicators was 0.8203 and 0.9104,respectively.By contrast,an increase in FEV≥12%and 200 mL demonstrated a sensitivity of 62.32%,specificity of 82.50%,and accuracy of 65.59%in diagnosing asthma.The changes of MEF2s and MEFso before and after BD reversibility test may be of additional value in the clinical diagnosis of asthma,with cutoff values of 25%being the most.

关 键 词：ASTHMA bronchodilator reversibility test maximum expiratory flow at 25%of vital capacity maximum expiratory flow at 50%of vital capacity 

分 类 号：R56[医药卫生—呼吸系统]