便携式肺功能仪在粉尘作业人员慢性阻塞性肺疾病筛查中的应用  

Application of Portable Spirometer in Chronic Obstructive Pulmonary Disease Screening for Dust Workers

作　　者：王寅银 宁津 WANG Yinyin;NING Jin(Department of Occupational Medicine,Tianjin Third Central Hospitalwranch,Tianjin 300250,China)

机构地区：[1]天津市第三中心医院(分院)职业病科,天津300250

出　　处：《河南医学研究》2022年第3期400-403,共4页Henan Medical Research

摘　　要：目的观察便携式肺功能仪在粉尘作业人员慢性阻塞性肺疾病(COPD)筛查中的应用效果。方法选取2019年1—12月于天津市第三中心医院(分院)职业病科行职业健康体检的粉尘作业人员402例,分别接受常规肺功能仪和便携式肺功能仪检查,并对结果进行比较。采用Kappa检验评价常规肺功能仪与便携式肺功能仪诊断COPD的一致性。以支气管扩张剂之后第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)<70%为截点,计算便携式肺功能仪判断COPD的敏感性、特异性、阳性预测值和阴性预测值。结果在本研究中,共检出符合COPD诊断者84例,占20.90%(84/402)。一致性分析显示,Kappa值为0.795,常规肺功能仪与便携式肺功能仪判断COPD的一致性良好(P<0.05)。常规肺功能仪与便携式肺功能仪检测FEV_(1)[(1.53±0.59)L比(1.58±0.66)L]、FVC[(2.51±0.80)L比(2.74±0.87)L]、FEV_(1)/FVC[(60.36±13.07)%比(57.84±13.52)%]、呼出25%用力肺活量时的用力呼气流速(FEF25%)[(76.85±29.71)L比(75.50±25.11)L]、FEF50%[(75.64±23.71)L比(73.35±23.03)L]及FEF75%[(77.07±21.24)L比(80.05±21.56)L]比较,差异均无统计学意义(P>0.05)。便携式肺功能仪诊断COPD的敏感度、特异度、阳性预测值和阴性预测值分别为94.05%(79/84)、96.54%(307/318)、87.78%(79/90)及98.40%(307/312)。结论便携式肺功能仪与常规肺功能仪诊断COPD的结果基本一致,对粉尘作业人员COPD筛查具有可行性,是一种理想的肺功能评估方法。Objective To observe the application efect of portable spirometer in chronie obstructive pulmonary disease(COPD)screening for dust workers.Methods A total of 402 dust workers who received health checkup in Tianjin Third Central Hospital Branch from January to December 2019 were selected.All subjects receveid the routine spirometer test and portable spirometer test,and the resuls were compared.Kappa test was used to evaluate the consistency of routine spirometer and portable spirometer in diagnosis COPD.After using bronchodilator,the forced expiratory volume in 1 second/forced vital capacity(FEV_(1)/FVC)<70%was taken as the cut-off point,and the sensitivity,specifieity,positive predictive value and negative predictive value of portable spirometer in the judgment of COPD were the calculated.Results A total of 84 cases[20.90%(84/402)]consistent with COPD diagnosis were detected.The consistency analysis showed that Kappa value was 0.795,routine spirometer and portable spirometer had a good consistency in diagnosing COPD(P<0.05).There was no significant difference on FEV_(1)[(1.53±0.59)L vs.(1.58±0.66)L],FVC[(2.51±0.80)Lvs.(2.74±0.87)L],FEV_(1)/FVC[(60.36±13.07)%vs.(57.84±13.52)%],for cedexpiratory flow rateat25%of forced lung capacity(FEF25%)[(76.85±29.71)Lvs.(75.50±25.11)L],FEF50%[(75.64±23.71)L vs.(73.35±23.03)L]and FEF75%[(77.07±21.24)Lvs.(80.05±21.56)L]betwee routine spirometer and portable spirometer(P>0.05).The sensitivity,specificity,positive predictive value and negative predictive value of portable spirometer in the diagnosis of COPD were 94.05%(79/84),96.54%(307/318),87.78%(79/90)and 98.40%(307/312),respectively.Conclusion The diagnostic results of routine spirometer and portable spirometer are basically the same,and portable spirometer is feasible to screen C0PD for dust workers,and it is an ideal method to evaluate lung function.

关 键 词：便携式肺功能仪 接触粉尘 慢性阻塞性肺疾病 

分 类 号：R563[医药卫生—呼吸系统]