fef25 ~ 75%与哮喘的临床诊断。

Annals of allergy Pub Date : 1994-09-01
W M Alberts, M C Ferris, S M Brooks, A L Goldman
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引用次数: 0

摘要

非特异性支气管激发试验在临床评价有哮喘症状的患者中是有用的。检测通常保留给基线肺活量正常或接近正常的患者。虽然支气管激发试验是安全且广泛可用的,但该方案耗时且并非没有费用。据报道,在螺旋体图正常的情况下,FEF25-75%的下降表明应该考虑哮喘。为了评估这一建议,我们比较了基线FEF25-75%(以预测的百分比表示)与随后的甲胆碱支气管激发试验的结果,对205例连续患者进行了检测。112例气道正常反应患者(即支气管激发试验阴性)的平均基线FEF25-75%为95.4±27.5%。在93例支气管激发试验阳性患者中,平均FEF25-75%为77.6±27.2%。气道高反应组FEF25-75%的平均值显著低于对照组(t = 4.616, P < 0.0001)。然而,在支气管激发试验阳性的患者中,基线FEF25-75%与PC20FEV1评估的支气管高反应性程度之间没有显著相关性(r = 0.154, P = 0.141)。当FEF25-75%的显著降低定义为低于预测值的60%时,预测规则的敏感性为25.8%,特异性为92.0%,阳性预测值为72.7%,阴性预测值为60.0%。根据这些结果,我们得出结论,简单肺活量测定法得出的FEF25-75%可能有助于预测支气管高反应性的存在与否,但不能预测支气管高反应性的程度。
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The FEF25-75% and the clinical diagnosis of asthma.

Nonspecific bronchial provocation testing is clinically useful in the evaluation of patients with symptoms suggestive of asthma. Testing is usually reserved for those with normal or near normal baseline spirometry. Although bronchial provocation testing is safe and widely available, the protocol is time consuming and not without expense. It has been reported that a reduced FEF25-75% in the context of an otherwise normal spirogram suggests that asthma should be considered. To evaluate this suggestion, we compared the baseline FEF25-75% (expressed as percent of predicted) with the results of the subsequent methacholine bronchial provocation test in 205 consecutive patients referred for testing. The mean baseline FEF25-75% in the 112 patients with normally responsive airways (ie, a negative bronchial provocation test) was 95.4 +/- 27.5%. In the 93 patients with a positive bronchial provocation test, the mean FEF25-75% was 77.6 +/- 27.2%. The mean FEF25-75% in those with hyperresponsive airways was significantly lower (t = 4.616, P < .0001). Of those patients with a positive bronchial provocation test, there was no significant correlation, however, between the baseline FEF25-75% and the degree of bronchial hyperresponsiveness as assessed by the PC20FEV1 (r = .154, P = .141). When a significant reduction in FEF25-75% was defined as less than 60% of predicted, the sensitivity of the prediction rule was 25.8%, the specificity was 92.0%, the positive predictive value was 72.7%, and the negative predictive value was 60.0%. From these results, we conclude that the FEF25-75% derived from simple spirometry may be useful in predicting the presence or absence, but not the degree, of bronchial hyperresponsiveness.

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