Division of Rehabilitation Medicine, Chiba University Hospital, Chiba, Japan; Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Neuromuscul Disord. 2024 Aug;41:29-34. doi: 10.1016/j.nmd.2024.06.003. Epub 2024 Jun 8.
Decreased cough strength in myasthenia gravis (MG) leads to aspiration and increases the risk of MG crisis. The aim of this study was to clarify the reliability and validity of cough peak flow (CPF) measurements in MG. A total of 26 patients with MG who underwent CPF measurements using the peak flow meter by themselves were included. MG symptoms were evaluated by pulmonary function tests and clinical MG assessment scales before and after immune-treatments. The relationship between CPF and pulmonary function tests and MG comprehensive were assessed. The cut-off value of CPF for aspiration risk was determined and the area under the curve (AUC) was calculated. The intraclass correlation coefficient was more than 0.95 for pre-and post-treatment. Positive correlations were found between CPF and almost all spirometric values as well as between the differences of pre-and post-treatment in CPF and quantitative myasthenia gravis score. The CPF for identifying the aspiration risk was used to calculate the CPF cut-off value of 205 L/min with a sensitivity of 0.77, specificity of 0.90, and AUC of 0.85. The CPF, a convenient measure by patients themselves, has a high reliability in patients with MG, and is a useful biomarker reflecting MG symptoms.
重症肌无力（MG）患者咳嗽力度减弱会导致误吸，增加 MG 危象的风险。本研究旨在阐明咳嗽峰流速（CPF）测量在 MG 中的可靠性和有效性。共纳入 26 例自行使用峰流速仪进行 CPF 测量的 MG 患者。在免疫治疗前后，通过肺功能检查和临床 MG 评估量表评估 MG 症状。评估 CPF 与肺功能检查和 MG 综合评估的相关性。确定 CPF 用于评估误吸风险的截断值，并计算曲线下面积（AUC）。治疗前后 CPF 的组内相关系数均大于 0.95。CPF 与几乎所有的肺活量值呈正相关，CPF 治疗前后差值与定量重症肌无力评分呈正相关。用于识别误吸风险的 CPF 计算 CPF 截断值为 205 L/min，灵敏度为 0.77，特异性为 0.90，AUC 为 0.85。CPF 是患者自行测量的一种便捷方法，在 MG 患者中具有很高的可靠性，是一种反映 MG 症状的有用生物标志物。
