中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2009年
5期
365-368
,共4页
哮喘%诊断'显像%支气管扩张药%呼吸音
哮喘%診斷'顯像%支氣管擴張藥%呼吸音
효천%진단'현상%지기관확장약%호흡음
Asthma%Diagnostic imaging%Brochodilator agents%Respiratory sounds
目的 初步探讨振动反应成像(VRI)检查对诊断支气管哮喘(简称哮喘)患者气流受限可逆性的价值.方法 选择2007年北京协和医院呼吸内科门诊就诊的哮喘患者64例为哮喘组,COPD患者20例为对照组.VRI设备采用VRI<'x,p>系统.按随访步骤(问诊、查体、肺功能检查、VRI检查)采集两组患者临床及VRI资料.应用符号秩和检验分别比较哮喘组和对照组应用支气管舒张剂 前后VRI各变量的2次观测结果,并将其差值与FEV1改善率进行多元线性回归拟合.对拟合模型的预报结果进行受试者工作曲线(ROC曲线)分析,获得本试验诊断的敏感度和特异度并评价其准确性.结果 哮喘组的VRI曲线异常、跳跃感、最大能量图(MEF)形态异常和干啰音单位计数4个变量,在应用支气管舒张剂前后2次观测结果的筹异有统计学意义(M值分别为7.5、14.5、12.5和7.5,均P<0.05),而对照组差异无统计学意义(M值分别为0.5、2.0、0.5和1.0,均P>0.05).所有受试者VRI 4个变量在应用支气管舒张剂前后2次观测的差值x1、x2、x3、x4与FEV1改善率Y之间应用多元线性回归模型拟合得出Y=0.127 84+0.067 67x1+0.047 23x2+0.049 19x3+0.003 91x4(F=10.16,P<0.01).ROC曲线分析提示本研究诊断气流受限可逆性的敏感度为81.3%,特异度为55.0%,ROC曲线下面积为0.704.结论 VRI中曲线异常、跳跃感、MEF形态异常及干啰音单位计数这4个变量对诊断哮喘患者气流受限的可逆性有一定价值.
目的 初步探討振動反應成像(VRI)檢查對診斷支氣管哮喘(簡稱哮喘)患者氣流受限可逆性的價值.方法 選擇2007年北京協和醫院呼吸內科門診就診的哮喘患者64例為哮喘組,COPD患者20例為對照組.VRI設備採用VRI<'x,p>繫統.按隨訪步驟(問診、查體、肺功能檢查、VRI檢查)採集兩組患者臨床及VRI資料.應用符號秩和檢驗分彆比較哮喘組和對照組應用支氣管舒張劑 前後VRI各變量的2次觀測結果,併將其差值與FEV1改善率進行多元線性迴歸擬閤.對擬閤模型的預報結果進行受試者工作麯線(ROC麯線)分析,穫得本試驗診斷的敏感度和特異度併評價其準確性.結果 哮喘組的VRI麯線異常、跳躍感、最大能量圖(MEF)形態異常和榦啰音單位計數4箇變量,在應用支氣管舒張劑前後2次觀測結果的籌異有統計學意義(M值分彆為7.5、14.5、12.5和7.5,均P<0.05),而對照組差異無統計學意義(M值分彆為0.5、2.0、0.5和1.0,均P>0.05).所有受試者VRI 4箇變量在應用支氣管舒張劑前後2次觀測的差值x1、x2、x3、x4與FEV1改善率Y之間應用多元線性迴歸模型擬閤得齣Y=0.127 84+0.067 67x1+0.047 23x2+0.049 19x3+0.003 91x4(F=10.16,P<0.01).ROC麯線分析提示本研究診斷氣流受限可逆性的敏感度為81.3%,特異度為55.0%,ROC麯線下麵積為0.704.結論 VRI中麯線異常、跳躍感、MEF形態異常及榦啰音單位計數這4箇變量對診斷哮喘患者氣流受限的可逆性有一定價值.
목적 초보탐토진동반응성상(VRI)검사대진단지기관효천(간칭효천)환자기류수한가역성적개치.방법 선택2007년북경협화의원호흡내과문진취진적효천환자64례위효천조,COPD환자20례위대조조.VRI설비채용VRI<'x,p>계통.안수방보취(문진、사체、폐공능검사、VRI검사)채집량조환자림상급VRI자료.응용부호질화검험분별비교효천조화대조조응용지기관서장제 전후VRI각변량적2차관측결과,병장기차치여FEV1개선솔진행다원선성회귀의합.대의합모형적예보결과진행수시자공작곡선(ROC곡선)분석,획득본시험진단적민감도화특이도병평개기준학성.결과 효천조적VRI곡선이상、도약감、최대능량도(MEF)형태이상화간라음단위계수4개변량,재응용지기관서장제전후2차관측결과적주이유통계학의의(M치분별위7.5、14.5、12.5화7.5,균P<0.05),이대조조차이무통계학의의(M치분별위0.5、2.0、0.5화1.0,균P>0.05).소유수시자VRI 4개변량재응용지기관서장제전후2차관측적차치x1、x2、x3、x4여FEV1개선솔Y지간응용다원선성회귀모형의합득출Y=0.127 84+0.067 67x1+0.047 23x2+0.049 19x3+0.003 91x4(F=10.16,P<0.01).ROC곡선분석제시본연구진단기류수한가역성적민감도위81.3%,특이도위55.0%,ROC곡선하면적위0.704.결론 VRI중곡선이상、도약감、MEF형태이상급간라음단위계수저4개변량대진단효천환자기류수한적가역성유일정개치.
Objective To explore the value of vibration response imaging (VRI) system in evaluating airway resistance of asthmatics.Methods The asthmatic group had 64 patients with a FEV1 of (56±18)% predicted before bronchodilator,and a FEV1 of (69±18)% predicted after bronchodilator.The control group had 20 patients with COPD with a FEV1 of (64±17)% predicted before bronchodilator,and a FEV1 of (66±19)% predicted after bronchodilator.All patients underwent VRI examination in close proximity of each spirometric recording before and after bronchodilator.VRI outcomes were evaluated to determine whether the VRI technology could detect changes in airway resistance in asthmatics.The statistical analysis in comparison between VRI outcomes before and after bronchodilator was performed using a matched pairs signed rank test.Linear regression was used to describe the relation between the improvements of VRI parameters and the increase in FEV1.ROC curve was used to evaluate the accuracy of this examination.Results After bronchodilator,VRI outcomes including flow graph characteristics,dynamic appearance,shape of the maximal energy frame and rale counts had significant improvements after bronehodilator (M=7.5,14.5,12.5,7.5,respectively,all P<0.05).Outcomes in the control group showed no significant improvements (M =0.5,2.0,0.5,1.0,respectively,all P > 0.05).y =0.127 84 + O.067 67x1 + 0.047 23x2 + 0.049 19x3 + O.003 91x4 was the model of the linear regression between improvements of VRI parameters (x1、x2、x3、x4) and the observed changes in FEV～ (y),F = 10.16,P <0.01.According to the bronchadilation test,the sensitivity was 81.3%,and the specificity was 55.0%.The area under the ROC curve was 0.704.Conclusion VRI outcomes including graph characteristics,dynamic appearance,shape of the MEF and rale counts may be a promising method to evaluate changes of airway resistance in asthmatics.
