呼气峰流速日变异率和哮喘控制测试在哮喘诊治中的作用.docVIP

呼气峰流速日变异率及哮喘控制测试在哮喘诊治中的作用 中南大学湘雅医院 摘要：目的：探讨呼气峰流速日变异率与哮喘控制测试评分的关系。分别探讨他们在哮喘中的应用价值。方法：选取2013年7月-2013年12月我院门诊就诊哮喘患者64人为研究对象。以一天四次（6：00,12:00,18:00,24:00）方法记录其最大呼气峰流速值（PEF）。计算每日呼气峰流速日变异率及个体平均值，每位患者就诊时常规记录患者哮喘控制测试评分（ACT）及一秒钟呼气率占预计值百分比（FEV1%）。结果：呼气峰流速日变异率显示与FEV1%及ACT评分均无相关关系，但ACT与FEV1%有较好的相关关系（r=0.389，P0.01），其直线回归关系为FEV1%=55.092±0.995ACT。呼气峰流速日变异率ROC曲线下面积0.976（截点为0.2，敏感性100%，特异度85.4%，阳性率41%）ACT监测哮喘的ROC曲线下面积0.652，阳性率为34%。呼气峰流速日变异率ACT诊断哮喘的ROC曲线下面积0.767（敏感性49%，特异度100%，阳性率54%）。未控制哮喘患者（ACT20或呼气峰流速日变异率20%ACT评分与呼气峰流速日变异率ACT≥20及呼气峰流速日变异率≤20%ACT评分与呼气峰流速日变异率r=-0.602， P≤0.01），其直线回归关系为呼气峰流速日变异率=0.530±0.170ACT。结论：哮喘患者ACT评分可以用于推测患者FEV1%肺功能指标。呼气峰流速日变异率ACT既能单独监测哮喘，也可以合用提高准确性。在未控制的哮喘患者，即ACT20或呼气峰流速日变异率20%者，ACT与呼气峰流速日变异率ACT评分来推测呼气峰流速日变异率the value of application of peak expiratory flow variation rate and asthma control test in monitoring patients with bronchialasthma. Abstract：Objective：In order to explore the value of application of peak expiratory flow variation rate and asthma control test in monitoring patients with bronchialasthma. Methods：Sixty-four asthmatic patients were collected from section for outpatients of the second affiliated hospital of wenzhou medical university dating from july.2013 to December.2013. their peak expiratory flow readings were determined with four times a day (6:00, 12:00, 18:00, 24:00). Calculate the daily peak expiratory flow variation rate and the average individually, at the same time record of asthma control test scores (ACT) and a second breath rate of expected percentage (FEV1 %).Analysis the value of application of peak expiratory flow variation rate and asthma control test in monitoring patients with bronchialasthma. Results：Peak expiratory flowvariation rate shows no relationship with FEV1 % and ACT scores, but ACThas good correlation with FEV1 % (r = 0.389, P 0.01), the linear regression relationship is FEV1 % = 55.092 + 0.995 ACT.the ROC-AUC of peak expiratory flow variation ratein the diagnotion of asthma 0.976 (cutoff point 0.2, sensitivity 10