Can peak expiratory flow predict airflow obstruction in children with asthma?
Can peak expiratory flow predict airflow obstruction in children with asthma?
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DOI：
10.1542/peds.105.2.354
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发表时间：
2000-02-01
期刊：
影响因子：
8
通讯作者：
Sheikh, S
中科院分区：
文献类型：
--
作者：
Eid, N;Yandell, B;Sheikh, S
研究目的。最近哮喘治疗的一个趋势是广泛、独立地使用呼气峰流量（PEF）。我们研究了PEF监测是否会导致中重度哮喘儿童评估的不准确性。比较不同空气潴留程度下，PEF与1秒用力呼气量（FEV 1）、25%~ 75%肺活量用力呼气流量（FEF 25 -75%）的阴性预测值，并以残气量与肺总容量比值（RV/TLC）进行比较。该研究纳入了244名患者，年龄在4至18岁之间，患有各种哮喘严重程度，FEV 1范围为预测值的28%至134%。我们分析了367套肺功能测试进行了整个3年的时间。PEF值正常的患者中有30%的患者FEV 1或FEF 25 - 75%异常。随着空气滞留增加，正常PEF预测正常FEV 1和FEF 25 -75%读数的能力从83%下降到53%。RV/TLC比值>30的患者的阴性预测值显著低于RV/TLC比值>30的患者
Study Objectives. A recent trend in the treatment of asthma has been the widespread, independent use of peak expiratory flow (PEF). We examined whether PEF monitoring creates inaccuracies in assessment of children with moderate to severe asthma.Methods. We compared the negative predictive value of PEF in relation to the forced expiratory volume in 1 second (FEV1), and to the forced expiratory flow between 25% and 75% of the vital capacity (FEF25-75%) at different levels of air trapping as determined by the residual volume over total lung capacity ratio (RV/TLC).Results. The study included 244 patients, ages 4 to 18 years with all classes of asthma severity, with FEV1 ranging from 28% to 134% of predicted value. We analyzed 367 sets of pulmonary function tests performed throughout a 3-year period. Thirty percent of patients with a normal PEF value had an abnormal FEV1 or FEF25-75%. As air trapping increased, the ability of a normal PEF to predict normal FEV1 and FEF25-75% readings fell from 83% to 53%. The negative predictive value was significantly lower for patients with RV/TLC ratio >30 compared with patients with RV/TLC