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肺量测定法和呼吸震荡测定法:哮喘患儿的可行性和一致性。

Spirometry and respiratory oscillometry: Feasibility and concordance in schoolchildren with asthma.

机构信息

Department of Pediatrics, Río Hortega University Hospital, Valladolid, Spain.

School of Medicine, University of Valladolid, Valladolid, Spain.

出版信息

Pediatr Pulmonol. 2023 Jul;58(7):1896-1903. doi: 10.1002/ppul.26409. Epub 2023 Apr 17.

Abstract

OBJECTIVE

The purpose of this study was to describe the feasibility of respiratory oscillometry (RO) in schoolchildren with asthma, and the concordance of its results with those of spirometry, to determine its clinical usefulness.

METHODS

RO and spirometry were performed in 154 children (6 to 14-year-old) with asthma, following strict quality criteria for the tests. Their feasibility (probability of valid test, time of execution, number of maneuvers needed to achieve a valid test, and perceived difficulty) was compared. The factors that influence feasibility were analyzed with multivariate methods. FEV1, FEV1/FVC, FVC and FEF25-75 for spirometry, and R5, AX and R5-19 for RO, were converted into z-scores and their concordance was investigated through intraclass correlation coefficients (ICC) and kappa indices for normal/abnormal values.

RESULTS

There were no differences in the probability of obtaining a valid RO or spirometry (83.1% vs. 81.8%, p = 0.868). RO required a lower number of maneuvers [mean (SD) 4.2 (1.8) versus 6.0 (1.6), p < 0.001] and less execution time [5.1 (2.7) versus 7.6 (2.4) minutes, p < 0.001], and patients considered it less difficult. Age increased the probability of obtaining valid RO and spirometry. The concordance of results between RO and spirometry was low, and only between zFEV1 and zAX could it be considered moderate (ICC = 0.412, kappa = 0.427).

CONCLUSION

RO and spirometry are feasible in children with asthma. RO has some practical advantages, but the concordance of its results with spirometry is low.

摘要

目的

本研究旨在描述呼吸震荡法(RO)在哮喘患儿中的可行性,以及其结果与肺活量计的一致性,以确定其临床应用价值。

方法

按照严格的测试质量标准,对 154 名(6 至 14 岁)哮喘患儿进行 RO 和肺活量计检查。比较其可行性(有效测试的概率、执行时间、达到有效测试所需的操作次数以及感知难度)。采用多变量方法分析影响可行性的因素。将肺活量计的 FEV1、FEV1/FVC、FVC 和 FEF25-75,以及 RO 的 R5、AX 和 R5-19,转换为 z 分数,并通过内类相关系数(ICC)和正常/异常值的kappa 指数来研究其一致性。

结果

RO 和肺活量计获得有效结果的概率无差异(83.1%与 81.8%,p=0.868)。RO 需要的操作次数更少[平均值(标准差)4.2(1.8)与 6.0(1.6),p<0.001],执行时间更短[5.1(2.7)与 7.6(2.4)分钟,p<0.001],且患者认为其难度较低。年龄增加了获得有效 RO 和肺活量计结果的概率。RO 与肺活量计结果的一致性较低,只有 zFEV1 与 zAX 之间可以认为是中度一致(ICC=0.412,kappa=0.427)。

结论

哮喘患儿的 RO 和肺活量计均可行。RO 具有一些实际优势,但与肺活量计的结果一致性较低。

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