Diagnostic Accuracy of Bronchodilator Response for Asthma in a Population of South China
Diagnostic Accuracy of Bronchodilator Response for Asthma in a Population of South China
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华南地区人群哮喘支气管扩张反应的诊断准确性
DOI：
10.1007/s12325-018-0783-0
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发表时间：
2018-09
影响因子：
3.8
通讯作者：
Juntao Feng
中科院分区：
文献类型：
--
作者：
Shichuan Zhang;Chengping Hu;Rongli Lu;Ruichao Niu;Xinyue Hu;Ling Qin;Ruoxi He;Juntao Feng
根据2005年美国胸科学会(ATS)/欧洲呼吸学会（ERS）标准，明显的支气管扩张剂反应通常定义为fev1较基线变化12%或以上，且≥200ml。许多研究表明，ATS/ERS标准在哮喘诊断方面存在局限性，一些专家主张对标准进行修正。本研究的目的是探讨急性支气管扩张剂反应对中国南方人群哮喘的诊断价值。方法对805例阻塞性肺疾病患者（哮喘309例，非哮喘496例）进行前瞻性评价。肺活量测定按照ATS/ERS指南进行。数据采用SPSS 18.0进行分析。绘制受试者工作特征（ROC）曲线，评价基于FEV1的ATS/ERS诊断标准的诊断准确性。采用线性回归分析影响fev1变化的因素。结果急性支气管扩张剂试验在ATS/ERS标准下（≥200ml，提高12%）的敏感性和特异性分别为68.6%和78.2%。对于ATS/ERS标准，综合反映诊断测试真实性的约登指数为46.8%。FEV1的绝对变化与基线FEV1、体重呈正相关，与年龄呈负相关；FEV1的百分比变化与基线FEV1、年龄、身高呈负相关，与体重呈正相关。比较不同的诊断值，当∆fev1为195 ml，∆fev1 %为14%时，约登指数最大（48.2%），该试验的诊断能力最大。结论ATS/ERS急性支气管扩张剂反应标准可能不完全适用于中国哮喘人群。中国临床试验注册中心（注册编号：ChiCTR-DDT-14004976）。基金资助：国家自然科学基金（资助号：81670027,81270080）。
IntroductionA significant bronchodilator response is commonly defined as a 12% or greater and 200 ml or greater change in FEV1from baseline according to the 2005 American Thoracic Society (ATS)/European Respiratory Society (ERS) criterion. A number of studies have shown that the ATS/ERS criterion has limitations in asthma diagnosis, and some experts have argued for correcting the criteria. The aim of this study is to investigate the diagnostic value of acute bronchodilator response for asthma in a Southern Chinese population.MethodsWe prospectively evaluated 805 patients with obstructive lung disease (309 for asthma, 496 for non-asthma). Spirometry was performed according to the ATS/ERS guidelines. Data were analyzed by SPSS 18.0. The receiver-operating characteristic (ROC) curve was drawn to assess the diagnostic accuracy of the ATS/ERS criterion based on FEV1. Linear regression was used to analyze the factors of FEV1change.ResultsThe sensitivity and specificity of the acute bronchodilator test when judged by the ATS/ERS criteria (200 ml or higher and 12% improvement) were 68.6% and 78.2%, respectively. For the ATS/ERS criteria, the Youden Index, which comprehensively reflects the authenticity of a diagnostic test, was 46.8%. The absolute change of FEV1positively correlated with baseline FEV1and weight and negatively with age, while the percentage change of FEV1was negatively correlated with baseline FEV1, age and height and positively with weight. Compared with the different diagnostic values, when ∆FEV1was 195 ml and ∆FEV1i% was 14%, the Youden Index was the largest (48.2%) and the diagnostic capability of the test the biggest.ConclusionsThe ATS/ERS criterion for acute bronchodilator response might not be completely suitable for asthma in the Chinese population.Trial RegistrationChinese Clinical Trial Registry (Registry ID: ChiCTR-DDT-14004976).FundingThis work was supported by the National Natural Science Foundation of China (grant nos. 81670027, 81270080).
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DOI：
10.2147/copd.s948
发表时间：
2008
影响因子：
2.8
作者：
Richter DC;Joubert JR;Nell H;Schuurmans MM;Irusen EM
通讯作者：
Irusen EM
影响因子：
14.2
作者：
Appleton, SL;Adams, RJ;Ruffin, RE
通讯作者：
Ruffin, RE
影响因子：
10
作者：
P. Tweeddale;F. Alexander;G. Mchardy
通讯作者：
P. Tweeddale;F. Alexander;G. Mchardy
影响因子：
2.2
作者：
J. Gjevre;T. Hurst;R. Taylor-Gjevre;D. Cockcroft
通讯作者：
J. Gjevre;T. Hurst;R. Taylor-Gjevre;D. Cockcroft
DOI：
--
发表时间：
2016
期刊：
--
影响因子：
--
作者：
J. Goldman;Julene K. Johnson;K. McElligott;O. Suchowersky;B. Miller;V. Deerlin
通讯作者：
J. Goldman;Julene K. Johnson;K. McElligott;O. Suchowersky;B. Miller;V. Deerlin