Using Voluntary Cough To Detect Penetration and Aspiration During Oropharyngeal Swallowing in Patients With Parkinson Disease
Using Voluntary Cough To Detect Penetration and Aspiration During Oropharyngeal Swallowing in Patients With Parkinson Disease
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DOI：
10.1378/chest.10-0342
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发表时间：
2010-12-01
期刊：
影响因子：
9.6
通讯作者：
Sapienza, Christine
中科院分区：
文献类型：
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作者：
Pitts, Teresa;Troche, Michelle;Sapienza, Christine
背景帕金森病（PD）患者中吸入性肺炎的发生率较高，因此识别有吸入性风险的PD患者非常重要。（Hoehn和Yahr分期II-III，平均年龄72 3岁）参加了一项研究，该研究测量了自愿咳嗽产生期间的气流和3盎司口咽吞咽任务的渗透/吸入程度，结果检测高危人群，（在3盎司吞咽任务中具有渗透和/或吸入的那些），自愿咳嗽的四个客观指标（压缩相持续时间[CPD]、呼气相上升时间[EPRT]、呼气相峰值流量[EPPF]和咳嗽体积加速度[CVA）]）被收集CPD、EPRT，EPPF和CVA测量产生显著的曲线下面积（AUC）分析，似然比分别等于0.83272、0.71268、0.69175和0.781842，CPD、EPRT、EPPF和CVA测量的敏感性分别为95.83%、70.83%、87.50%和84.53%，特异性分别为64.71%、73.53%、50.01%和97.06%。在检测误吸时，EPPF与AUC = 0.88和EPPF与AUC = 0.88显著相关，
Background Identification of people with Parkinson disease (PD) who are at risk for aspiration is important, especially because of the high prevalence of aspiration pneumoniaMethods Fifty-eight consecutive patients (Hoehn and Yahr stage II-III average age 72 3) were enrolled in the study Measures of airflow during voluntary cough production and the degree of penetration/aspiration on a 3-oz oropharyngeal swallow task, derived from videofluorographic images, were examinedResults To detect at-risk people (those with penetration and/or aspiration on the 3-oz swallow task), four objective measures of voluntary cough (compression phase duration [CPD], expiratory phase rise time [EPRT], expiratory phase peak flow [EPPF], and cough volume acceleration [CVA)]) were collected CPD, EPRT, EPPF, and CVA measurements produced significant area under the curve (AUC) analyses and likelihood ratios equal to 0 83 2 72, 0 71 2 68, 0 69 1 75, and 0 78 18 42, respectively CPD, EPRT, EPPF, and CVA measurements demonstrated sensitivities of 95 83%, 70 83%, 87 50%, and 84 53%, and specificities of 64 71%, 73 53%, 50 01%, and 97 06%, respectively For detection of aspiration, EPPF was significantly associated with an AUC =0 88 and with an EPPF