PEF与COPD气流阻塞判定指标的相关性研究

发布时间：2018-05-08 20:40

本文选题：COPD + 气流阻塞　；参考：《宁夏医科大学》2013年硕士论文

【摘要】：研究目的探讨呼气峰流速（PEF）对慢性阻塞性肺疾病（COPD）气流阻塞严重程度的评估与FEV1对COPD严重程度分级的相关性及临床意义。研究方法 2008年6月—2013年1月在宁夏医科大学总医院门诊就诊的60例COPD患者及同期于我院体检的60例健康人群，回顾性收集肺功能中FVC、FEV1、FEV1/FVC与PEF等呼吸参数，分析PEF与FEV1的相关性、PEF筛查COPD气流阻塞的敏感性、特异性与准确度及以PEF诊断COPD气流阻塞的ROC曲线。研究结果 1、慢性阻塞性肺疾病（COPD）患者60例，FEV1与PEF的相关系数（r）0.815（P=0.0000.01）。对照组60例，FEV1与PEF的相关系数（r）0.306（P=0.0170.05）。COPD组与对照组，FEV1与PEF均呈直线正相关（P0.05），COPD组FEV1与PEF的相关系数明显高于正常组。 2、COPD组中，轻度气流阻塞（GOLD1）患者3例，FEV1与PEF的相关系数（r）为-1（P=0.117㧐0.05）；中度气流阻塞（GOLD2）患者38例，FEV1与PEF的相关系数（r）为0.315（P=0.0060.01）；重度气流阻塞（GOLD3）患者11例，FEV1与PEF的相关系数（r）为0.624（P=0.0080.01）；极重度气流阻塞（GOLD4）患者8例，FEV1与PEF的相关系数（r）为0.830（P=0.0050.01）。 3、COPD组中，吸烟患者42例，FEV1与PEF的相关系数（r）为0.732（P=0.0000.01）；不吸烟患者18例，FEV1与PEF的相关系数（r）为0.420 （P=0.0160.05）。 4、按气流阻塞严重程度分析PEF在筛查轻-极重度、中-极重度以及重-极重度气流受限中的作用，得出PEF70%pred其筛查气流受限的敏感性、特异性及准确性较高，可以筛查出81.67%经过肺功能检查证实的气流阻塞患者；PEF70%pred，可以筛查出85.9%经过肺功能检查证实的中-极重度气流受限患者；PEF60%pred可以筛查出100%重度-极重度气流受限。 5、以PEF做COPD气流阻塞的诊断性试验，其ROC曲线下面积为0.912。结论 1、PEF与FEV1在COPD患者中有良好的相关性。 2、COPD气流阻塞程度越重，，其相关性越好；COPD组中，吸烟患者的相关性较非吸烟患者的相关性强。 3、PEF作为初步筛选COPD气流阻塞的一个辅助指标，具有一定的临床可行性。
[Abstract]:Purpose of research To investigate the correlation between peak expiratory flow rate (PEF) and FEV1 in evaluating the severity of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD) and its clinical significance. Research method From June 2008 to January 2013, 60 patients with COPD and 60 healthy people who were examined in our hospital from June 2008 to January 2013 were collected retrospectively. The respiratory parameters such as FEV1 / FEV1 / FVC and PEF were collected retrospectively. The correlation between PEF and FEV1 was analyzed. The sensitivity, specificity and accuracy of COPD airflow obstruction screening were analyzed. The ROC curve of PEF was used to diagnose COPD airflow obstruction. Research results 1. The correlation coefficient between FEV1 and PEF in 60 patients with chronic obstructive pulmonary disease (COPD) was 0.0000.01. The correlation coefficient between FEV1 and PEF in the control group was significantly higher than that in the normal group. The correlation coefficient between FEV1 and PEF in the control group and the control group was significantly higher than that in the control group. The correlation coefficient between FEV1 and PEF in the control group was significantly higher than that in the normal group. 2in COPD group, The correlation coefficient between FEV1 and PEF in 3 patients with mild airflow obstruction was 0. 117 / 0. 05 渭 m; in 38 patients with moderate airflow obstruction / GOLD2), the correlation coefficient between FEV1 and PEF was 0. 315- P0. 0060. 01; in 11 patients with severe airflow obstruction (GOLD3), the correlation coefficient between FEV1 and PEF was 0. 624P0. 01; that of PEF was 0. 624P0. 01; and that between FEV1 and PEF was 0. 624P0. 01; the correlation coefficient between FEV1 and PEF was 0. 624P0. 01; The correlation coefficient between FEV1 and PEF in 8 patients with flow obstruction (GOLD4) was 0.830 渭 g / L 0.0050.01g / L. The correlation coefficient between FEV1 and PEF in 42 smoking patients was 0.732P 0.0000.01g, and the correlation coefficient between FEV1 and PEF in 18 non-smoking patients was 0.420. P0. 016. 05. 4. According to the severity of airflow obstruction, the role of PEF in the screening of airflow limitation was analyzed. The results showed that the sensitivity, specificity and accuracy of PEF70%pred in screening airflow limitation were high. 81.67% of the patients with airflow obstruction confirmed by pulmonary function test could be screened out, and 85.9% of the patients with moderate to very severe airflow limitation confirmed by pulmonary function test could be screened out by PEF60pred, and 100% of the patients with severe to very severe airflow limitation could be screened. 5. Using PEF as diagnostic test for COPD airflow obstruction, the area under ROC curve was 0.912. Conclusion There was a good correlation between PEF and FEV1 in COPD patients. (2) the more severe the airflow obstruction degree of COPD, the better the correlation was. In COPD group, the correlation of smoking patients was stronger than that of non-smoking patients. 3 PEF as an auxiliary index for primary screening of COPD airflow obstruction has certain clinical feasibility.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.9

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