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M J Mas Fazlin1, Z H Ching1, A A Azat1
1Universiti Kebangsaan Malaysia, Faculty of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia.
The Medical journal of Malaysia
|January 30, 2024
概括
脉冲振荡计 (IOS) 是螺旋计的可行替代品,用于诊断成人喘,有效识别支气管扩展器可逆性和小气道疾病 (SAD). IOS显示SAD的检测率高于螺旋计,特别是在没有显著的支气管扩展剂反应的患者中.
科学领域:
- 肺部医学 肺部医学
- 呼吸系统诊断 呼吸系统诊断
- 临床生理学 临床生理学
背景情况:
- 螺旋计是喘诊断的黄金标准,但需要患者的大量合作.
- 脉冲振荡计 (IOS) 提供了一种可替代的诊断方法,要求合作减少.
- 喘诊断依赖于识别气流阻塞和支气管扩展器可逆性.
研究的目的:
- 评估脉冲振荡计 (IOS) 和螺旋计参数之间的相关性,以诊断喘.
- 评估IOS检测小气道疾病 (SAD) 和支气管扩展器可逆性 (BDR) 的能力.
- 为了比较IOS和螺旋计的诊断性能,特别是FEF25%-75%,在患喘的成年人中.
主要方法:
- 这是一项涉及82名成年喘患者的横截面研究,该研究在Canselor Tuanku Muhriz (HCTM) 医院进行.
- 参与者在同一天接受了支气管扩展前和后的IOS和螺旋测量.
- 进行了统计分析,以确定IOS和螺旋计参数之间的相关性,包括FEF25%-75%和IOS衍生的SAD指标.
主要成果:
- 在1秒内强制呼气体积 (FEV1) 的变化与IOS参数R5.5的变化之间发现了显著的相关性.
- 在R5下降14.5%与阳性支气管扩展剂反应 (BDR) 相相关,显示63.9%的灵敏度和60.9%的特异性 (p=0.007).
- 支气管扩张前药物FEF25%-75%与SAD的IOS参数相关 (R5-R20,X5,AX) (p <0.05). 在91.3%的BDR阴性患者中,IOS检测到SAD,而在FEF25%-75%患者中,SAD的比例为58.7%.
结论:
- 脉冲振荡计 (IOS) 可以被认为是成人喘的替代诊断工具.
- IOS有效地检测出支气管扩展器可逆性和小气道疾病 (SAD).
- 与FEF25%-75%相比,IOS显示出SAD的更高的检测能力,特别是在BDR负组中.
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