Flietstra B, Markuzon N, Vyshedskiy A, Murphy R
The Charles Stark Draper Laboratories, Massachusetts Institute of Technology, Faulkner Hospital, 1153 Centre Street, Suite 4990 Boston, MA 02130, USA.
Pulm Med. 2011;2011:590506. doi: 10.1155/2011/590506. Epub 2010 Dec 21.
Background. The crackles in patients with interstitial pulmonary fibrosis (IPF) can be difficult to distinguish from those heard in patients with congestive heart failure (CHF) and pneumonia (PN). Misinterpretation of these crackles can lead to inappropriate therapy. The purpose of this study was to determine whether the crackles in patients with IPF differ from those in patients with CHF and PN. Methods. We studied 39 patients with IPF, 95 with CHF and 123 with PN using a 16-channel lung sound analyzer. Crackle features were analyzed using machine learning methods including neural networks and support vector machines. Results. The IPF crackles had distinctive features that allowed them to be separated from those in patients with PN with a sensitivity of 0.82, a specificity of 0.88 and an accuracy of 0.86. They were separated from those of CHF patients with a sensitivity of 0.77, a specificity of 0.85 and an accuracy of 0.82. Conclusion. Distinctive features are present in the crackles of IPF that help separate them from the crackles of CHF and PN. Computer analysis of crackles at the bedside has the potential of aiding clinicians in diagnosing IPF more easily and thus helping to avoid medication errors.
背景。间质性肺纤维化（IPF）患者的啰音可能难以与充血性心力衰竭（CHF）和肺炎（PN）患者的啰音相区分。对这些啰音的错误解读可能导致不恰当的治疗。本研究的目的是确定IPF患者的啰音是否与CHF和PN患者的啰音不同。方法。我们使用16通道肺音分析仪研究了39例IPF患者、95例CHF患者和123例PN患者。使用包括神经网络和支持向量机在内的机器学习方法分析啰音特征。结果。IPF啰音具有独特特征，使其能够与PN患者的啰音区分开来，敏感性为0.82，特异性为0.88，准确性为0.86。它们与CHF患者的啰音区分开来，敏感性为0.77，特异性为0.85，准确性为0.82。结论。IPF啰音存在独特特征，有助于将其与CHF和PN的啰音区分开来。床边对啰音进行计算机分析有可能帮助临床医生更轻松地诊断IPF，从而有助于避免用药错误。
