Maximum Phonation Time as a Surrogate Marker for Airway Clearance Physiologic Capacity and Pulmonary Function in Individuals With Amyotrophic Lateral Sclerosis.
Maximum Phonation Time as a Surrogate Marker for Airway Clearance Physiologic Capacity and Pulmonary Function in Individuals With Amyotrophic Lateral Sclerosis.
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最大发声时间作为肌萎缩侧索硬化症患者气道清除生理能力和肺功能的替代标志。
DOI：
10.1044/2022_jslhr-22-00522
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Plowman,EmilyK
中科院分区：
文献类型：
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作者：
TaborGray,Lauren;Donohue,Cara;Vasilopoulos,Terrie;Wymer,JamesP;Plowman,EmilyK
目的越来越多地使用远程医疗实践，对肌萎缩性侧索硬化症（pALS）患者疾病进展的预后呼吸指标的家庭替代标志物产生了迫切需求。考虑到发声依赖于语音产生的呼吸子系统，我们旨在研究最大发声时间（MPT）、用力肺活量和咳嗽峰值流量之间的关系，并确定MPT在pal中检测用力肺活量和咳嗽峰值流量障碍的判别能力。方法每3个月从62例pal （El-Escorial Revised）中获得mpt、峰值咳嗽流量、用力肺活量和ALS功能评定量表评分，作为纵向自然病史研究的一部分。计算Pearson相关、线性回归和曲线下面积（AUC）、敏感性、特异性和似然比的接收者算子特征曲线分析。结果pal患者平均年龄为63.14±10.95岁，女性占49%，球茎发病占43%。MPT预测用力肺活量，F(1,225) = 117.96,p< 0.0001；预测咳嗽峰值流量，F(1,217) = 98.79,p< 0.0001。MPT与ALS功能评定量表-强制肺活量修订呼吸评分之间存在显著的交互作用，F(1,222) = 6.7,p= 0.010，峰值咳嗽流量F(1,215) = 4.37,p= 0.034。MPT对峰值咳嗽流量的鉴别能力很好（AUC = 0.88），对用力肺活量的鉴别能力也可以接受（AUC = 0.78）。结论smpt是一种简单的临床测试，可通过远程医疗进行测量，是重要的呼吸和气道清除率指标的潜在替代指标。需要进一步进行更大规模的研究，通过远程数据收集来验证这些发现。补充Materialhttps: / / doi.org/10.23641/asha.22186408
PurposeThe increased use of telehealth practices has created a critical need for home-based surrogate markers for prognostic respiratory indicators of disease progression in persons with amyotrophic lateral sclerosis (pALS). Given that phonation relies on the respiratory subsystem of speech production, we aimed to examine the relationships between maximum phonation time (MPT), forced vital capacity, and peak cough flow and to determine the discriminant ability of MPT to detect forced vital capacity and peak cough flow impairments in pALS.MethodMPT, peak cough flow, forced vital capacity, and ALS Functional Rating Scale scores were obtained from 62 pALS (El-Escorial Revised) every 3 months as part of a longitudinal natural history study. Pearson's correlations, linear regressions, and receiver operator characteristic curve analyses with the area under the curve (AUC), sensitivity, specificity, and likelihood ratios were calculated.ResultsThe mean age of pALS was 63.14 ± 10.95 years, 49% were female, and 43% had bulbar onset. MPT predicted forced vital capacity,F(1, 225) = 117.96,p< .0001, and peak cough flow,F(1, 217) = 98.79,p< .0001. A significant interaction was noted between MPT and ALS Functional Rating Scale–Revised respiratory subscore for forced vital capacity,F(1, 222) = 6.7,p= .010, and peak cough flow,F(1, 215) = 4.37,p= .034. The discriminant ability of MPT was excellent for peak cough flow (AUC = 0.88) and acceptable for forced vital capacity (AUC = 0.78).ConclusionsMPT is a simple clinical test that can be measured via telehealth and represents a potential surrogate marker for important respiratory and airway clearance indices. Further larger studies are required to validate these findings with remote data collection.Supplemental Materialhttps://doi.org/10.23641/asha.22186408