探讨VRI在支气管哮喘诊断过程中的临床应用价值

Investigation of Clinical Value of VRI in Asthma Diagnosis

目的使用振动反应成像(vibration response imaging,VRI)对支气管舒张试验患者的呼吸音动态图像进行分析,并与肺功能相关指标比较,初步探讨VRI在支气管哮喘(简称哮喘)患者诊断过程中的应用价值。方法选择141例在门诊进行气支管舒张试验的患者,舒张试验前后分别进行VRI检查和肺功能测定,比较舒张试验阳性组以及阴性组前后VRI各项指标的差别;将各项差值与FEV1改善率和改善容积进行线型回归分析,以及ROC分析;统计舒张试验阳性组VRI各指标改善与恶化的比例。结果①支气管舒张试验结果:舒张试验阳性77例(FEV1%平均改善率14.18%),阴性64例。②VRI结果:阳性组舒张试验后,振动能量曲线评分、动态图像跳跃感、干啰音、EVP同步性较舒张试验前明显好转(P<0.01),阴性组舒张试验后各指标无明显变化。③舒张试验阳性组VRI结果,包括振动能量曲线评分、图像总分、EVP同步性、干啰音与FEV1改善率相关。④ROC曲线提示振动能量曲线分析在哮喘诊断中的灵敏度为63%,特异度为81%;EVP同步性的灵敏度为55%,特异度为78%。结论 VRI在哮喘诊断过程中有一定的应用价值。

Objective Using vibration response imaging device (VRI) to analysis the dynamic image of breath sounds in patients with bronchial dilation tests. Through comparing the date of VRI with the corresponding indicators of lung function,preliminarily investigate the value of the VRI on diagnostic process of patients with asthma.Methods To select 141 cases of patients with manifold dilation test in out-patient department. VRI tests and pulmonary function tests were used before and after the dilation tests, then compared the differences of VRI index between dilation test positive group and negative group.We used the linear regression analysis and ROC analysis between the difference value with FEV1 improvement rate and improved capacity.Calculate the proportion of improvement and deterioration VRI index value during the dilation test positive group.Results ①Dilation test results:77 cases positive (average improvement rate of FEV1% was 14.18%),64 cases negative.②VRI result:The vibration energy curve score, jumping flu of dynamic image, dry rales, Expiratory vibration energy peak (EVP) synchronization of positive group after dilation test were much better than the group before the dilation test (P<0.01), while there were no significant change in negative group.③The indexes with correlation between VRI result of positive group in dilation test and FEV1 improvement rate in lung function were Vibration energy curve score, image score,EVP synchronization,dry rales and FEV1 improvement rate.④ROC curve prompt that the sensitivity in the vibrational energy curve analysis in the diagnosis of asthma was 63%,specificity was 81%.And sensitivity of EVP synchronization was 55% in,specificity asthma was 63%,specificity was 81%.And sensitivity of EVP synchronization was 55% in,specificity of EVP synchronization was 78%.Conclusions Certain value of VRI in the process of asthma diagnosis is existed.