Patterns of changes and diagnostic values of FEF50%, FEF25%-75% and FEF50%/FEF25%-75% ratio in patients with varying control of bronchial asthma
Patterns of changes and diagnostic values of FEF50%, FEF25%-75% and FEF50%/FEF25%-75% ratio in patients with varying control of bronchial asthma
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DOI：
10.12816/0031221
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发表时间：
2016-01-01
影响因子：
2
通讯作者：
Lutfi, Mohamed Faisal
中科院分区：
文献类型：
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作者：
Lutfi, Mohamed Faisal
背景：FEF50%、FEF25%-75%和FEF50%/FEF25%-75%比率的变化模式取决于用力呼气的机制，前提是在呼气流量-容积环中真实记录非均匀肺排空。目的：评价FEF50%、FEF25%-75%和FEF50%/FEF25%-75%比值作为支气管哮喘（BA）控制指标的潜在临床价值。方法：本研究纳入年龄和性别相匹配的75例BA患者和45例非哮喘患者。根据哮喘控制试验（ACT）和肺活量测定法将哮喘患者分为控制组和控制不良组。采用线性回归评估FEF50%与fef25% ~ 75%、FEF50%/ fef25% ~ 75%比值与ACT评分的关系。采用ROC曲线评估fef25 ~ 75%和FEF50%对不同哮喘控制程度患者BA诊断的信度。结果：FEF50%与fef25% ~ 75%呈强相关（r = 0.989, P < 0.001），二者关系为公式FEF50% = 1.132* fef25% ~ 75% - 0.003。FEF50%/FEF25-75%比值与ACT评分无显著相关（r = -0.159, P = 0.083）。fef25% ~ 75%对肺活量测定诊断BA的诊断能力仅略优于FEF50% (ROC曲线下面积分别为0.88和0.89,P < 0.001)；然而，两种肺活量指标的诊断能力随着BA控制不良而降低。结论：FEF50%/ fef25% ~ 75%作为BA控制指标无临床价值。fef25% ~ 75%对BA评价的作用略好于FEF50%；然而，随着BA控制的恶化，两项指标的效率均大幅下降。
Background: The pattern of change in FEF50%, FEF25%-75% and FEF50%/FEF25%-75% ratio depends on mechanics of forceful expiration, provided that non-homogenous lung emptying is faithfully recorded in the expiratory flow-volume loops.Objective: To assess the potential clinical value of FEF50%, FEF25%-75% and FEF50%/FEF25%-75% ratio as an indicator of bronchial asthma (BA) control.Methodology: The study involved 75 patients with BA matched for age and gender with 45 non-asthmatic subjects. Based on asthma control test (ACT) and spirometry, asthmatic patients were subdivided into controlled and poorly controlled/uncontrolled. The relationship between FEF50% and FEF25%-75% as well as FEF50%/FEF25%-75% ratio and ACT score were assessed using linear regression. ROC curves were used to assess reliability of FEF25%-75% and FEF50% to diagnose BA in patients with different degree of asthma control.Results: FEF50% correlated strongly with FEF25%-75% (r = 0.989, P < 0.001) and the relationship between the two indices is governed by the formula FEF50% = 1.132* FEF25%-75% - 0.003. There was no significant correlation (r = -0.159, P = 0.083) between FEF50%/FEF25-75% ratio and ACT score. The diagnostic capability of FEF25%-75% for spirometric diagnosis of BA is only marginally better compared to FEF50% (area under ROC curves were 0.88 and 0.89 respectively, P < 0.001); however, diagnostic power of both spirometric indices deceased with poor BA control.Conclusion: FEF50%/FEF25%-75% has no clinical value as an indicator for BA control. Role of FEF25%-75% in evaluation of BA is marginally better than FEF50%; however, efficiency of both indices declined substantially as BA control worsened.