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脉冲振荡法和支气管舒张试验在哮喘和慢性阻塞性肺疾病患者分析中的应用。

Application of impulse oscillometry and bronchial dilation test for analysis in patients with asthma and chronic obstructive pulmonary disease.

作者信息

Li Yueyue, Chen Yang, Wang Ping

机构信息

Department of Respiratory Medicine, 306 Hospital of PLA Beijing 100101, China.

出版信息

Int J Clin Exp Med. 2015 Jan 15;8(1):1271-5. eCollection 2015.

Abstract

Impulse oscillometry (IOS) is a good method for measuring airway resistance. The aim of this study was to assess the diagnostic contribution of IOS combined with bronchial dilation test (BDT) when distinguishing between patients with asthma and those with chronic obstructive pulmonary disease (COPD). 870 were enrolled in the study including 561 patients with asthma, 100 patients with COPD and 209 patients with chronic coughing or normal subjects. All the participants underwent routine pulmonary function tests, IOS and BDT examination. And IOS examination was before and after BDT. IOS parameters (R5, R20, R25, R35, X5, X20, X25, X35, Fres, Zrs & RP) and forced expiratory volume in one second (FEV1) were recorded. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the diagnostic ability to differentiate asthma and COPD. The discriminative power of the various parameters studied was determined by means of ROC curves: the area under the curve (AUC), sensitivity and specificity. The X5, X20, X25, X35, Fres, Zrs and Rp correlated better with COPD. In particular, X5, Fres and X25 have been found to be significantly correlated with COPD. The diagnostic efficiency of X5, Fres and X25 when diagnosis COPD, expressed by ROC curve parameters, was as follows: AUC (0.725, 0.730, 0.724), sensitivity (67%, 77%, 83%) and specificity (68%, 65%, 58%), respectively. The diagnostic efficiency of Zrs, R5 and X35 when diagnosis asthma, expressed by ROC curve parameters, was as follows: AUC (0.721, 0.710, 0.695), sensitivity (62%, 72%, 53%) and specificity (72%, 61%, 76%), respectively. Our findings show, that X5, X25 and Fres may be useful for predictions and evaluations for COPD. And R5, X35 and Zrs may provide useful IOS parameters for asthma. IOS combined BDT could be useful diagnostic and differential diagnosis between asthma and COPD.

摘要

脉冲振荡法(IOS)是测量气道阻力的一种好方法。本研究的目的是评估IOS联合支气管舒张试验(BDT)在区分哮喘患者和慢性阻塞性肺疾病(COPD)患者时的诊断价值。870名受试者纳入本研究,其中包括561例哮喘患者、100例COPD患者以及209例慢性咳嗽患者或正常受试者。所有参与者均接受常规肺功能检查、IOS及BDT检查。且IOS检查在BDT前后进行。记录IOS参数(R5、R20、R25、R35、X5、X20、X25、X35、Fres、Zrs及RP)及一秒用力呼气容积(FEV1)。采用受试者工作特征(ROC)曲线分析评估区分哮喘和COPD的诊断能力。通过ROC曲线确定所研究的各种参数的判别能力:曲线下面积(AUC)、敏感性和特异性。X5、X20、X25、X35、Fres、Zrs和Rp与COPD的相关性更好。特别是,已发现X5、Fres和X25与COPD显著相关。以ROC曲线参数表示,X5、Fres和X25诊断COPD时的诊断效能如下:AUC分别为(0.725、0.730、0.724),敏感性分别为(67%、77%、83%),特异性分别为(68%、65%、58%)。以ROC曲线参数表示,Zrs、R5和X35诊断哮喘时的诊断效能如下:AUC分别为(0.721、0.710、0.695),敏感性分别为(62%、72%、53%),特异性分别为(72%、61%、76%)。我们的研究结果表明,X5、X25和Fres可能有助于COPD的预测和评估。而R5、X35和Zrs可能为哮喘提供有用的IOS参数。IOS联合BDT可能有助于哮喘和COPD的诊断及鉴别诊断。

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