The interpretation of the spirogram. How accurate is it for 'obstruction'?
The interpretation of the spirogram. How accurate is it for 'obstruction'?
复制标题
呼吸图的解释。
DOI：
10.1001/archinte.1985.00360090103016
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发表时间：
1985
影响因子：
--
通讯作者：
J. Auchincloss
中科院分区：
文献类型：
--
作者：
R. Gilbert;J. Auchincloss
对 200 名受试者（其中 74 名有阻塞，126 名无阻塞）中的肺活量图根据气流受限检测或排除气道阻塞的准确性进行了前瞻性评估。气道阻塞的诊断基于临床和身体体积描记数据的结合。 1秒用力呼气量与用力肺活量之比（FEV1/FVC%）的敏感性为0.82，特异性为0.98。固定下限似乎比基于预测公式的下限更好。由于特异性远高于敏感性，因此在 FEV1/FVC % 异常时确认是否存在阻塞所需的精确临床信息比在 FEV1/FVC % 正常时排除阻塞所需的精确临床信息要少。与单独使用 FEV1/FVC % 相比，结合使用 FEV1/FVC % 和 FVC 50% 时的用力呼气流量 (FEF) 比率可提供更高的灵敏度和相当的特异性。 FEF 的正常值在 FVC 的 25% 到 75% 之间几乎排除了梗阻，但低值特异性较差。
The accuracy of the spirogram in detecting or excluding airway obstruction based on airflow limitation was assessed prospectively in 200 subjects, 74 with obstruction and 126 without it. The diagnosis of airway obstruction was based on a combination of clinical and body plethysmographic data. The ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC %) had a sensitivity of 0.82 and a specificity of 0.98. A fixed lower limit seemed better than a lower limit based on prediction formulas. Because specificity is so much higher than sensitivity, less precise clinical information is required to confirm the presence of obstruction if FEV1/FVC % is abnormal than is needed to exclude obstruction if FEV1/FVC % is normal. Using a combination of FEV1/FVC % and the ratio of forced expiratory flow (FEF) at 50% of FVC gave a higher sensitivity with a comparable specificity when compared with FEV1/FVC % used alone. A normal value for FEF between 25% and 75% of FVC virtually ruled out obstruction, but low values had poor specificity.