Murphy Raymond L H, Vyshedskiy Andrey, Power-Charnitsky Verna-Ann, Bana Dhirendra S, Marinelli Patricia M, Wong-Tse Anna, Paciej Rozanne
Brigham and Women's/Faulkner Hospital, 1153 Centre Street, Suite 40, Boston MA 02130, USA.
Respir Care. 2004 Dec;49(12):1490-7.
To determine whether objectively detected lung sounds were significantly different in patients with pneumonia than those in asymptomatic subjects, and to quantify the pneumonia findings for teaching purposes.
At a community teaching hospital we used a multi-channel lung sound analyzer to examine a learning sample of 50 patients diagnosed with pneumonia and 50 control subjects. Automated quantification and characterization of the lung sounds commonly recognized to be associated with pneumonia were used to generate an "acoustic pneumonia score." These were examined in the learning sample and then prospectively tested in 50 patients and 50 controls.
The acoustic pneumonia score averaged 13 in the learning sample and 11 in the test sample of pneumonia patients. The scores were 2 and 3 in the controls. The positive predictive value of a score higher than 6 was 0.94 in the learning sample and 0.87 in the test sample. The sensitivities in the 2 groups were 0.90 and 0.78, and the specificities were 0.94 and 0.88, respectively. Adventitious sounds were more common in pneumonia patients (inspiratory crackles 81% vs 28%, expiratory crackles 65% vs 9%, rhonchi 19% vs 0%).
Our lung sound analyzer found significant differences between lung sounds in patients with pneumonia and in asymptomatic controls. Computerized lung sound analysis can provide objective evidence supporting the diagnosis of pneumonia. We believe that the lung-sound data produced by our device will help to teach physical diagnosis.
确定肺炎患者客观检测到的肺音与无症状受试者的肺音是否存在显著差异,并为教学目的量化肺炎的检查结果。
在一家社区教学医院,我们使用多通道肺音分析仪对50例确诊为肺炎的患者和50例对照受试者的样本进行检查。使用自动量化和表征通常被认为与肺炎相关的肺音,以生成“声学肺炎评分”。在学习样本中对这些评分进行检查,然后在前瞻性研究中对50例患者和50例对照进行测试。
在肺炎患者的学习样本中,声学肺炎评分平均为13分,测试样本中平均为11分。对照组的评分为2分和3分。评分高于6的阳性预测值在学习样本中为0.94,在测试样本中为0.87。两组的敏感性分别为0.90和0.78,特异性分别为0.94和0.88。附加音在肺炎患者中更常见(吸气性啰音81%对28%,呼气性啰音65%对9%,哮鸣音19%对0%)。
我们的肺音分析仪发现肺炎患者与无症状对照者的肺音存在显著差异。计算机化肺音分析可为肺炎诊断提供客观依据。我们相信我们设备产生的肺音数据将有助于物理诊断教学。