Astograph法支气管激发试验对哮喘诊断价值的研究

Study on Astograph Bronchial Provocation Test for the Diagnosis of Asthma

目的评价Astograph法支气管激发试验在哮喘诊断中的价值。方法测定80例哮喘患者和125例非哮喘患者的肺功能和气道反应性、敏感性,应用统计学方法分析两组指标间的差异,寻找能够诊断哮喘的指标及其临界值。结果肺功能各项指标哮喘组均低于非哮喘组(FVC除外)。激发试验指标Dmin和PD35哮喘组低于非哮喘组(P<0.01),但Rrs、Grs、SGrs、SGrs/Grs间的差异无统计学意义(P>0.05)。哮喘组中SGrs与Dmin、PD35正相关(P<0.01;r=0.5029,0.2937)。非哮喘组SGrs与PD35相关(P<0.01,r=-0.4264)。以Dmin诊断哮喘,ROC曲线下面积为0.956,临界值5.9165,敏感性0.966,特异性0.925。以PD35诊断哮喘,ROC曲线下面积为0.949,临界值13.277,敏感性0.977,特异性0.895。结论 Astograph法气道激发试验有助于支气管哮喘的诊断,其中以Dmin≤5.9165 Unit或PD35≤13.277 Unit为阳性标准有较好的特异性及敏感性。

Objective To evaluate the role of astograph bronchial provocation test in diagnosis of asthma.Methods Evaluated 80 asthmatics and 125 non-asthmatics patients with lung function,airway responsiveness and sensitivity.Applied statistical methods to analyze differences between two groups,looking for indicators of asthma diagnosis and their critical value.Results Except FVC,the lung function of asthmatic group were lower than non-asthmatic group.Dmin and PD35 of asthmatic group were lower than non-asthmatic group（P0.01）,but there were no significant differences between Rrs,Grs,SGrs and SGrs/Grs of two groups（P0.05）.In asthmatic group,SGrs was correlated with Dmin and PD35（P0.01;r=0.5029,0.2937）.In non-asthmatic group SGrs was correlated with PD35（P0.01,r=-0.4264）.In ROC analysis：Dmin presented an AUC of 0.956,the cut-off value is 5.9165,with a sensitivity of 0.966 and specificity of 0.925.PD35 presented an AUC of 0.949,the cut-off value is 13.277,with a sensitivity of 0.977 and specificity of 0.895.Conclusion Astograph bronchial provocation test had good specificity and sensitivity in the diagnosis of asthma,especially when the Dmin≤5.9165 Unit or PD35≤13.277 Unit as the cutoff value.