如何最好地诊断可能的喘患者的肺部扩展器可逆性测试负?
Buket Başa Akdoğan1, Ilkay Koca Kalkan1, Gözde Köycü Buhari1
1Department of Chest Diseases, Division of Immunology and Allergy, University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
Journal of asthma and allergy
|February 27, 2024
概括
峰值呼气流 (PEF) 变异性是诊断喘的一个有用工具,特别是在阴性支气管扩展剂可逆性测试 (BDRT) 的患者中. 对于PEF变化的值≥20%可以确认喘,而<15%可以帮助排除它.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 喘诊断可能具有挑战性,特别是在阴性支气管扩展剂可逆性测试 (BDRT) 的患者中.
- 目前对喘的诊断策略缺乏对这一特定患者群体的明确指导方针.
- 高峰呼气流 (PEF) 的变化是诊断喘的潜在生物标志物.
研究的目的:
- 评估疑似喘和负BDRT的患者PEF变异的诊断效用.
- 确定最佳的PEF可变性值,以此种人群中诊断喘.
- 在BDRT阴性个体中识别喘的其他潜在诊断标志物.
主要方法:
- 招募了50名疑似喘和负BDRT患者的队列.
- 在两周内监测PEF变异性,同时进行甲林支气管诱导测试 (mBPT).
- 喘诊断是基于PEF变异性 (≥20%) 和/或阳性mBPT.
主要成果:
- 在50名患者中,有30人被诊断患有喘.
- 在不同的截止值下,PEF变异性表现出不同的灵敏度和特异性 (例如,在>10%时100%的灵敏度).
- 低基线FEF25-75被确定为喘诊断的独立预测因子 (p=0.05).
结论:
- 对于BDRT阴性患者,建议PEF变化值为<15%的排除和≥20%的确认.
- 在喘评估中,应考虑FEF25-75作为一个有价值的诊断参数.
- 需要进一步的研究来完善喘诊断标准,以应对具有挑战性的病例.
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