Assessment Of Ratio Of Peak Expiratory Flow Rate To Vital Capacity For Identifying Pulmonary Fibrosis.

IF 1.2 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Stacey D Lok, Donald W Cockcroft, Alexander Simidchiev
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引用次数: 1

Abstract

Background: Pulmonary fibrosis (PF) is associated with reduction in vital capacity (VC) and increase in expiratory flow rates, including peak expiratory flow (PEF). Full pulmonary function testing and computed tomography chest scans are limited resources in some geographic areas and a simple and sensitive screening test would be of value. We hypothesized that increase in the ratio of % predicted PEF over % predicted VC (%PEF/%VC), from spirometry alone might be sensitive to screen for pulmonary fibrosis.

Methods: The %PEF/%VC from 1,000 consecutive spirometric flow volume curves was nearly normally distributed: 7.5% (approximately 1.5 standard deviations) had a ratio ≥ 1.4. We evaluated the sensitivity and specificity of this cut point for a diagnosis of PF in a retrospective chart review of 391 patients with good quality spirometry and respirologists' confirmed diagnoses.

Results: Of the 391 patients analyzed, 98 had PF, 79 were normal, 70 had a combined obstructive and restrictive processes, 57 had obstructive lung disease, 61 had extra-parenchymal restriction and 26 had non-fibrotic interstitial lung disease. A %PEF/%VC ≥ 1.4 was only 54.1% sensitive in predicting PF, however it had a specificity of 94.9%. There was a 95.1% specificity for ruling in intra-parenchymal opposed to extra-parenchymal restriction.

Conclusion: A %PEF/%VC ≥ 1.4 was not sensitive enough to screen for PF but did demonstrate high specificity and thus may be helpful in identifying intraparenchymal restriction.

呼气峰值流速与肺活量之比对肺纤维化鉴别的评估。
背景:肺纤维化(PF)与肺活量(VC)降低和呼气流量(包括呼气峰值流量(PEF))增加有关。在某些地区,全肺功能测试和胸部计算机断层扫描资源有限,简单而敏感的筛查测试将是有价值的。我们假设仅从肺活量测定中预测PEF的百分比比预测VC的百分比(%PEF/%VC)的增加可能对肺纤维化筛查敏感。方法:1000条连续肺活量测定曲线的%PEF/%VC接近正态分布:7.5%(约1.5标准差)的比值≥1.4。我们通过对391例患者的回顾性图表回顾,评估了该切点诊断PF的敏感性和特异性,这些患者具有高质量的肺活量测定和呼吸科医生确诊的诊断。结果:391例患者中,PF 98例,正常79例,阻塞性和限制性合并70例,阻塞性肺疾病57例,肺实质外受限61例,非纤维化间质性肺疾病26例。%PEF/%VC≥1.4对PF的敏感性仅为54.1%,特异性为94.9%。判断实质内限制与实质外限制的特异性为95.1%。结论:%PEF/%VC≥1.4不足以筛查PF,但具有较高的特异性,因此可能有助于识别肺实质内限制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical and Investigative Medicine
Clinical and Investigative Medicine 医学-医学:研究与实验
CiteScore
1.50
自引率
12.50%
发文量
18
审稿时长
>12 weeks
期刊介绍: Clinical and Investigative Medicine (CIM), publishes original work in the field of Clinical Investigation. Original work includes clinical or laboratory investigations and clinical reports. Reviews include information for Continuing Medical Education (CME), narrative review articles, systematic reviews, and meta-analyses.
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