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目的评估第六秒用力呼气容积(FEV6)替代用力肺活量(FVC)筛选慢性阻塞性肺疾病(COPD)的效果,确定第一秒用力呼气容积(FEV1)/FEV6诊断界值。方法对2007年8月至2008年12月北京大学人民医院呼吸科1210例肺功能检查结果进行回顾性分析,在容量-时间曲线上测量FEV6,应用Kendall test对FEV1/FEV6与FEV1/FVC进行相关性分析;以FEV1/FVC<70%为金标准,绘制受试者工作特征曲线(ROCcurve),以敏感度与特异度之和最大为标准,确定诊断界值。结果FEV1/FEV6与FEV1/FVC高度相关(r=0.964,P<0.05)。以FEV1/FVC<70%为金标准FEV1/FEV6受试者工作特征曲线下面积为0.997,面积的标准误为0.001。以敏感度和特异度之和最大确定FEV1/FEV6最佳分界点为71%,敏感度为97.7%,特异度为99.1%。结论FEV1/FEV6与FEV1/FVC高度相关,以FEV1/FEV6<71%作为COPD诊断界值具有很高的敏感度和特异度。FEV1/FEV6可以替代FEV1/FVC用于筛选诊断COPD。
Objectives To assess the effectiveness of FEV6 in screening forced expiratory volume (FVC) for chronic obstructive pulmonary disease (COPD) and to determine the FEV1 / FEV6 diagnostic cutoff value for the first second forced expiratory volume (FEV6). Methods A retrospective analysis of 1210 pulmonary function tests was performed in Department of Respiratory Medicine, Peking University People’s Hospital from August 2007 to December 2008, FEV6 was measured on the volume-time curve, and correlation between FEV1 / FEV6 and FEV1 / FVC was evaluated using Kendall test The ROCcurve was plotted based on the gold standard of FEV1 / FVC <70%. The diagnostic criteria were determined based on the maximum sum of sensitivity and specificity. Results FEV1 / FEV6 was highly correlated with FEV1 / FVC (r = 0.964, P <0.05). Taking FEV1 / FVC <70% as gold standard The area under the working characteristic curve of FEV1 / FEV6 subjects was 0.997, with a standard error of area of 0.001. Based on the sum of sensitivity and specificity, the best cutoff point of FEV1 / FEV6 was 71%, the sensitivity was 97.7% and the specificity was 99.1%. Conclusion FEV1 / FEV6 is highly correlated with FEV1 / FVC, and FEV1 / FEV6 <71% is of high sensitivity and specificity in the diagnosis of COPD. FEV1 / FEV6 can replace FEV1 / FVC for screening for diagnosis of COPD.