Department of Respiratory & Critical Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Department of Pulmonary and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
Curr Med Sci. 2020 Aug;40(4):677-682. doi: 10.1007/s11596-020-2237-6. Epub 2020 Aug 29.
Changes of maximum expiratory flow at 25% and 50% of vital capacity (MEF and MEF, respectively), and predominant parameters indicating small airways function in asthmatics before and after bronchodilator (BD) reversibility test have been less interpreted. Our study aimed to investigate the clinical role of changes of MEF and MEF before and after BD reversibility test in diagnosing asthma. Forced expiratory volume in the first second (FEV), MEF, and MEF were measured before and after BD reversibility test in 207 asthmatic patients using standard process. Forty healthy individuals were enrolled as controls. Receiver operating characteristic (ROC) curve was used to assess the diagnostic accuracy of reversibility of MEF and MEF before and after BD reversibility test (ΔMEF% and ΔMEF%, respectively) in diagnosing asthma. Among these functional criteria, ΔMEF% and ΔMEF% ≥ 25% performed the best diagnostic performance. The sensitivity, specificity, and accuracy of ΔMEF% ≥ 25% as an objective diagnostic test for asthma were 63.29%, 87.50%, and 67.21%, and of ΔMEF% ≥ 25% were 79.23%, 85.00%, and 80.16%, respectively. The area under the ROC curve of the indicators was 0.8203 and 0.9104, respectively. By contrast, an increase in FEV ≥ 12% and 200 mL demonstrated a sensitivity of 62.32%, specificity of 82.50%, and accuracy of 65.59% in diagnosing asthma. The changes of MEF and MEF before and after BD reversibility test may be of additional value in the clinical diagnosis of asthma, with cutoff values of 25% being the most.
用力呼气量在 25%和 50%肺活量时的最大值（分别为 MEF 和 MEF）以及支气管扩张剂（BD）可逆性试验前后小气道功能的主要参数变化在哮喘患者中解释较少。我们的研究旨在探讨 MEF 和 MEF 在 BD 可逆性试验前后变化在哮喘诊断中的临床作用。在 207 例哮喘患者中，采用标准程序在 BD 可逆性试验前后测量了一秒用力呼气量（FEV）、MEF 和 MEF。40 名健康个体被纳入对照组。使用受试者工作特征（ROC）曲线评估 MEF 和 MEF 在 BD 可逆性试验前后（分别为ΔMEF%和ΔMEF%）的变化在诊断哮喘中的诊断准确性。在这些功能标准中，ΔMEF%和ΔMEF%≥25%表现出最佳的诊断性能。ΔMEF%≥25%作为哮喘客观诊断试验的敏感性、特异性和准确性分别为 63.29%、87.50%和 67.21%，而ΔMEF%≥25%的分别为 79.23%、85.00%和 80.16%。指标的 ROC 曲线下面积分别为 0.8203 和 0.9104。相比之下，FEV 增加≥12%和 200 mL 对哮喘的诊断具有 62.32%的敏感性、82.50%的特异性和 65.59%的准确性。BD 可逆性试验前后 MEF 和 MEF 的变化可能对哮喘的临床诊断具有附加价值，以 25%为截断值最为合适。
