Lundgren Fernando Luiz Cavalcanti, Cabral Marília Montenegro, Clímaco Danielle Cristina Silva, de Macedo Liana Gonçalves, Coelho Marta de Andrade Lima, Dias Ana Lúcia Pereira Lima Alves
Otávio de Freitas General Hospital, Recife, PE, Brasil.
J Bras Pneumol. 2007 Mar-Apr;33(2):148-51. doi: 10.1590/s1806-37132007000200008.
To determine the efficacy of using forced expiratory volume in six seconds (FEV6) as a surrogate for forced vital capacity (FVC) in the diagnostic screening for chronic obstructive pulmonary disease (COPD) by comparing FEV1/FVC ratios with FEV1/FEV6 ratios.
In November of 2003, on World COPD Day, we conducted a campaign of diagnostic screening for COPD. The participants completed the clinical questionnaire of the Global Initiative for Obstructive Lung Disease, and those who responded affirmatively to at least three questions underwent spirometry.
A total of 134 individuals responded to three questions affirmatively and underwent spirometry. Of those, 59 were excluded: 45 for being non-smokers and 14 due to the fact that their tests did not meet the American Thoracic Society criteria for satisfactory spirometry. The number of tests in which the FEV1/FEV6 ratio was below 70% was similar to that found for the FEV1/FVC ratio. The sensitivity of FEV1/FEV6 in diagnosing airway obstruction (defined as FEV1/FVC below 70%) was 92%, and its specificity was 99%. The positive predictive value was 100%, and the negative predictive value was 98%. The Kendall correlation test revealed r = 0.99 (p < 0.0001). The t-test for paired samples revealed a negative correlation: t = -5.93 (p < 0.0001).
The FEV1/FEV6 proved efficient for use in the diagnostic screening for COPD. There is a strong correlation between FEV1/FVC and FEV1/FEV6.
通过比较第1秒用力呼气容积(FEV1)与用力肺活量(FVC)的比值和FEV1与6秒用力呼气容积(FEV6)的比值,确定在慢性阻塞性肺疾病(COPD)诊断筛查中使用FEV6替代FVC的有效性。
2003年11月世界COPD日,我们开展了COPD诊断筛查活动。参与者完成了慢性阻塞性肺疾病全球倡议组织的临床问卷,对至少三个问题回答为肯定的人接受了肺功能检查。
共有134人对三个问题回答为肯定并接受了肺功能检查。其中,59人被排除:45人因非吸烟者,14人因检查不符合美国胸科学会满意肺功能检查标准。FEV1/FEV6比值低于70%的检查数量与FEV1/FVC比值的情况相似。FEV1/FEV6诊断气道阻塞(定义为FEV1/FVC低于70%)的敏感性为92%,特异性为99%。阳性预测值为100%,阴性预测值为98%。肯德尔相关性检验显示r = 0.99(p < 0.0001)。配对样本t检验显示呈负相关:t = -5.93(p < 0.0001)。
FEV1/FEV6被证明可有效用于COPD诊断筛查。FEV1/FVC与FEV1/FEV6之间存在很强的相关性。