Princess Amalia Children's Clinic, Isala klinieken, Zwolle, The Netherlands.
Pediatr Pulmonol. 2010 Apr;45(4):326-32. doi: 10.1002/ppul.21183.
Variation of lung function is considered to be a hallmark of asthma. Although guidelines recommend measuring it as a diagnostic tool for asthma, the usefulness of this approach has not been studied in children.
To assess the usefulness of home spirometry in children with nonspecific lower respiratory tract symptoms, to diagnose or exclude asthma.
In school-aged children, referred by their general practitioner because of chronic respiratory symptoms of unknown origin, the diagnosis of asthma was made or excluded by a pediatric pulmonologist (gold standard), based on international guidelines and a standardized protocol. Additionally, children measured peak expiratory flow (PEF) and forced expiratory flow in 1 sec (FEV(1)) twice daily for 2 weeks on a home spirometer, from which diurnal variation was calculated. These results (index test) were not revealed to the pediatric pulmonologist. The value of home spirometry to diagnose asthma was calculated.
Sixty-one children (27 boys) were included (mean age: 10.4 years; range: 6-16 years). Between asthma and no asthma, the mean difference in PEF variation was 4.4% (95% CI: 0.9-7.9; P = 0.016) and in FEV(1) variation 4.5% (95% CI: 1.6-7.4; P = 0.003). Sensitivity and specificity, based on the 95th-centile of the reference values for PEF and FEV(1) variation (12.3% and 11.8%, respectively) were 50% and 72% for PEF variation and 45% and 92% for FEV(1) variation. The likelihood ratio was 1.8 for PEF and 5.6 for FEV(1).
The contribution of home spirometry in the diagnostic process for asthma in schoolchildren with nonspecific respiratory symptoms is limited.
肺功能变化被认为是哮喘的一个标志。尽管指南建议将其作为哮喘的诊断工具进行测量，但尚未在儿童中研究这种方法的实用性。
评估家庭肺功能测定在患有非特异性下呼吸道症状的儿童中的作用，以诊断或排除哮喘。
在学龄儿童中，由于慢性呼吸道症状的原因，他们由全科医生转诊，根据国际指南和标准化方案，由儿科肺科医生（金标准）做出或排除哮喘的诊断。此外，儿童在家庭肺功能计上每天两次测量两次呼气峰流速（PEF）和 1 秒用力呼气量（FEV1），并计算出日变异率。这些结果（指标测试）未向儿科肺科医生揭示。计算家庭肺功能测定诊断哮喘的价值。
共纳入 61 名儿童（27 名男孩）（平均年龄：10.4 岁；范围：6-16 岁）。在哮喘和非哮喘之间，PEF 变异的平均差异为 4.4%（95%CI：0.9-7.9；P=0.016），FEV1 变异的平均差异为 4.5%（95%CI：1.6-7.4；P=0.003）。基于 PEF 和 FEV1 变异的参考值第 95 百分位数（分别为 12.3%和 11.8%），PEF 变异的灵敏度和特异性分别为 50%和 72%，FEV1 变异的灵敏度和特异性分别为 45%和 92%。PEF 的似然比为 1.8，FEV1 的似然比为 5.6。
家庭肺功能测定在患有非特异性呼吸道症状的学龄儿童哮喘诊断过程中的作用有限。
