心肺运动试验对慢性阻塞性肺疾病患者气流受限严重程度的预测价值

Predictive value of cardiopulmonary exercise test for severity of airflow limitation in patients with chronic obstructive pulmonary disease

目的探究心肺运动试验与慢性阻塞性肺疾病(简称慢阻肺)患者气流受限严重程度的关系,以期发现可用于预测COPD患者气流受限的可靠指标,为临床早期诊断和治疗慢阻肺提供参考依据。方法选取单纯稳定期COPD患者作为研究对象。使用logistic回归分析分析COPD患者气流受限严重程度的影响因素,并使用受试者工作特征(ROC)曲线分析各指标对COPD患者气流受限严重程度的诊断价值。结果控制年龄、性别、吸烟、饮酒、BMI后,VEmax[OR=0.571,95%CI(0.363~0.899)]与VO_(2)peak[OR=0.174,95%CI(0.044~0.690)]为COPD患者气流受限的保护因素,且VEmax与VO_(2)peak诊断COPD患者气流受限严重程度的ROC曲线下面积分别为[AUC=0.953,95%CI(0.883~0.987)]、[AUC=0.907,95%CI(0.823~0.960)]。结论心肺运动试验中的VO_(2)peak与VEmax可作为COPD患者气流受限严重程度的早期预测诊断指标,具有重要的临床应用价值。

Objective To explore the relationship between cardiopulmonary exercise test(CPET)and the severity of airflow limitation in patients with chronic obstructive pulmonary disease(COPD),with a view to identifying reliable indicators that can predict airflow limitation in these patients,providing reference for early diagnosis and treatment of COPD.Methods Patients with stable COPD who visited the outpatient department of Respiratory and Critical Care Medicine,General Hospital of Ningxia Medical University were selected as subjects.logistic regression analysis was used to analyze the influencing factors of the severity of airflow limitation in patients with COPD,and ROC curve analysis was used to evaluate the diagnostic value of each indicator for the severity of airflow limitation in patients with COPD.Results After controlling for age,gender,smoking,alcohol consumption,and BMI,VEmax[OR=0.571,95%CI(0.363~0.899)]and VO_(2)peak[OR=0.174,95%CI(0.044~0.690)]were protective factors for airflow limitation in patients with COPD.The area under the ROC curve(AUC)of VEmax and VO_(2)peak in diagnosing the severity of airflow limitation in patients with COPD were[AUC=0.953,95%CI(0.883~0.987)]and[AUC=0.907,95%CI(0.823~0.960)]respectively.Conclusion VO_(2) peak and VEmax in CPET can be used as early prediction and diagnosis index of the severity of airflow limitation in patients with COPD,which has important clinical application value.