Brain Rehabilitation and Research Center, Malcom Randall VA Medical Center, Gainesville; Department of Physiological Sciences, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville.
College of Veterinary Medicine, Department of Behavioral Science and Community Health, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville.
Chest. 2014 May;145(5):1089-1096. doi: 10.1378/chest.13-0596.
Dysphagia and aspiration pneumonia are two causes of morbidity in Parkinson disease (PD). In PD, impaired airway clearance can lead to penetration of foreign material, resulting in a high prevalence of aspiration pneumonia and death. This study examines three different devices for measurement of peak airflow during voluntary cough in healthy control subjects and those with PD. Two simple and low-cost devices for measuring peak cough airflow were compared with the "gold standard" pneumotachograph.
Thirty-five healthy control subjects and 35 individuals with PD produced voluntary cough at three perceived strengths (weak, moderate, and strong cough) for each of the three devices.
A significant difference in mean peak cough airflow was demonstrated for disease (F[1,56] = 4.0, P < .05) and sex (F[1,56] = 9.59, P < .003) across devices. The digital and analog meters were comparable to the gold standard demonstrating no significant difference (statistical) by device (digital vs analog) in receiver operating characteristic curve analysis. Both devices were discriminative of the presence of PD.
The analog and digital peak airflow meters are suitable alternatives to the gold standard pneumotachograph due to their low cost, portability, ease of use, and high sensitivity relative to normative peak cough airflows. Voluntary cough airflow measures may serve as a noninvasive means of screening for aspiration risk in target populations. Additionally, quantification of cough strength through use of predetermined limens for weak, moderate, and strong cough may assist clinicians in better describing and tracking cough strength as a contributing factor to aspiration risk.
吞咽困难和吸入性肺炎是帕金森病（PD）发病的两个原因。在 PD 中，气道清除能力受损可导致异物穿透，导致吸入性肺炎和死亡的高患病率。本研究检查了三种不同的设备，用于测量健康对照者和 PD 患者自愿咳嗽时的峰值气流。两种简单且低成本的测量最大咳嗽气流的设备与“金标准”测压计进行了比较。
35 名健康对照者和 35 名 PD 患者在三种感知强度（弱、中、强咳嗽）下对三种设备进行自愿咳嗽。
疾病（F[1,56] = 4.0，P <.05）和性别（F[1,56] = 9.59，P <.003）在设备之间显示出平均最大咳嗽气流的显著差异。数字和模拟表与金标准相比表现出无统计学差异（通过设备（数字与模拟）在接收器操作特征曲线分析中）。两种设备均能区分 PD 的存在。
由于成本低、便携性、易于使用以及相对于正常峰值咳嗽气流的高灵敏度，模拟和数字峰值气流计是金标准测压计的合适替代品。自愿咳嗽气流测量值可能成为针对目标人群的吸入风险进行筛查的一种非侵入性手段。此外，通过使用弱、中、强咳嗽的预定极限来量化咳嗽强度，可能有助于临床医生更好地描述和跟踪咳嗽强度作为吸入风险的一个因素。
