中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
34期
45-47
,共3页
呼吸功能试验%肺通气功能障碍%第6秒用力呼气容积%肺活量
呼吸功能試驗%肺通氣功能障礙%第6秒用力呼氣容積%肺活量
호흡공능시험%폐통기공능장애%제6초용력호기용적%폐활량
Respiratory function tests%Pulmonary ventilation disorder%Forced expiratory volume in 6 second%Vital capacity
目的 探讨应用第6秒用力呼气容积(FEV6)替代用力肺活量(FVC)用于阻塞性及限制性肺通气功能障碍的诊断.方法 对470例行肺功能检查的门诊患者进行回顾性分析,分别以第1秒用力呼气容积(FEV1)/FVC＜ 70％及FEV1/FVC正常而FVC占预计值百分比＜80％为标准,绘制受试者工作特征曲线,以灵敏度与特异度之和最大为标准,分别确定FEV1/FEV6及FEV6占预计值百分比的最佳诊断界值及灵敏度与特异度.采用交叉列联表方法计算准确率,采用Kappa检验判定一致性.结果 以FEV1/FVC＜ 70％为金标准,FEV1/FEV6诊断阻塞性及限制性肺通气功能障碍的最佳诊断界值为71％,灵敏度为97.5％(154/158),特异度为98.7％ (308/312),准确率为98.3％(462/470),Kappa=0.962 (P=0.000);以FEV1/FVC正常而FVC占预计值百分比＜80％为金标准,FEV6占预计值百分比诊断限制性肺通气功能障碍的最佳诊断界值为82％,灵敏度为96.1％(73/76),特异度为95.7％(222/232),准确率为95.8％(295/308),Kappa=0.890(P=0.000).结论 FEV6可以有效替代FVC用于阻塞性及限制性肺通气功能障碍的诊断,FEV1/FEV6诊断阻塞性及限制性肺通气功能障碍的最佳诊断界值为71％,FEV6占预计值百分比诊断限制性肺通气功能障碍的最佳诊断界值为82％.
目的 探討應用第6秒用力呼氣容積(FEV6)替代用力肺活量(FVC)用于阻塞性及限製性肺通氣功能障礙的診斷.方法 對470例行肺功能檢查的門診患者進行迴顧性分析,分彆以第1秒用力呼氣容積(FEV1)/FVC＜ 70％及FEV1/FVC正常而FVC佔預計值百分比＜80％為標準,繪製受試者工作特徵麯線,以靈敏度與特異度之和最大為標準,分彆確定FEV1/FEV6及FEV6佔預計值百分比的最佳診斷界值及靈敏度與特異度.採用交扠列聯錶方法計算準確率,採用Kappa檢驗判定一緻性.結果 以FEV1/FVC＜ 70％為金標準,FEV1/FEV6診斷阻塞性及限製性肺通氣功能障礙的最佳診斷界值為71％,靈敏度為97.5％(154/158),特異度為98.7％ (308/312),準確率為98.3％(462/470),Kappa=0.962 (P=0.000);以FEV1/FVC正常而FVC佔預計值百分比＜80％為金標準,FEV6佔預計值百分比診斷限製性肺通氣功能障礙的最佳診斷界值為82％,靈敏度為96.1％(73/76),特異度為95.7％(222/232),準確率為95.8％(295/308),Kappa=0.890(P=0.000).結論 FEV6可以有效替代FVC用于阻塞性及限製性肺通氣功能障礙的診斷,FEV1/FEV6診斷阻塞性及限製性肺通氣功能障礙的最佳診斷界值為71％,FEV6佔預計值百分比診斷限製性肺通氣功能障礙的最佳診斷界值為82％.
목적 탐토응용제6초용력호기용적(FEV6)체대용력폐활량(FVC)용우조새성급한제성폐통기공능장애적진단.방법 대470례행폐공능검사적문진환자진행회고성분석,분별이제1초용력호기용적(FEV1)/FVC＜ 70％급FEV1/FVC정상이FVC점예계치백분비＜80％위표준,회제수시자공작특정곡선,이령민도여특이도지화최대위표준,분별학정FEV1/FEV6급FEV6점예계치백분비적최가진단계치급령민도여특이도.채용교차렬련표방법계산준학솔,채용Kappa검험판정일치성.결과 이FEV1/FVC＜ 70％위금표준,FEV1/FEV6진단조새성급한제성폐통기공능장애적최가진단계치위71％,령민도위97.5％(154/158),특이도위98.7％ (308/312),준학솔위98.3％(462/470),Kappa=0.962 (P=0.000);이FEV1/FVC정상이FVC점예계치백분비＜80％위금표준,FEV6점예계치백분비진단한제성폐통기공능장애적최가진단계치위82％,령민도위96.1％(73/76),특이도위95.7％(222/232),준학솔위95.8％(295/308),Kappa=0.890(P=0.000).결론 FEV6가이유효체대FVC용우조새성급한제성폐통기공능장애적진단,FEV1/FEV6진단조새성급한제성폐통기공능장애적최가진단계치위71％,FEV6점예계치백분비진단한제성폐통기공능장애적최가진단계치위82％.
Objective To determine the value of forced expiratory volume in 6 second (FEV6) and forced expiratory volume in 1 second (FEV1)/FEV6 in diagnosis of obstructive and restrictive lung ventilation dysfunction.Methods A total of 470 cases receiving spirometric examinations were analyzed retrospectively.A subject was considered to have obstruction if FEV1/forced vital capacity (FVC) was ＜ 70％.The restriction was defined as FVC ＜ 80％ in the absence of obstruction.The best cut-off of FEV1/FEV6 and FEV6 were determined through receiver-operating characteristics curve,and the sensitivity,specificity,accuracy and Kappa of FEV1/FEV6 and FEV6 were calculated.Results It showed that the current cut-off points used to detect obstruction and restriction could be replaced by FEV1/FEV6 was 71％ and FEV6 was 82％,respectively.FEV1/FEV6 had sensitivity of 97.5％ (154/158),specificity of 98.7％ (308/312),accuracy of 98.3％ (462/470) and Kappa of 0.962 (P=0.000).For restrictive pattern,FEV6 had sensitivity of 96.1％(73/76),specificity of 95.7％ (222/232),accuracy of 95.8％ (295/308) and Kappa of 0.890 (P =0.000).Conclusions FEV6 can be a valid alternative for FVC in the diagnosis of obstructive and restrictive lung ventilation dysfunction.
