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目的:探讨小气道指标与非典型哮喘的关系,建立小气道指标预测非典型哮喘的回归方程。方法:对本院呼吸科门诊的612例合并有小气道病变的患者行支气管激发试验检测,比较小气道病变与气道高反应性诊断哮喘的阳性率,用Logistic回归分析建立小气道指标预测非典型哮喘的回归方程。结果:612例小气道病变患者中共有543例支气管激发试验阳性,阳性率为88.73%,其中有531例确诊为哮喘,用气道高反应性诊断哮喘的阳性率为97.79%,用小气道病变预测非典型哮喘的阳性率为86.76%。Logistic回归分析显示:小气道指标MMEF对哮喘的预测价值最高(P<0.01)。小气道指标预测非典型哮喘的回归方程为:P=Exp(7.486-0.091×MMEF-0.046×FEF_(50%)-0.018×FEF_(75%))/[1+Exp(7.486-0.091×MMEF-0.046×FEF_(50%)-0.018×FEF_(75%))]Exp(B)=0.913。结论:小气道指标检测简便易行,适用于我国不能开展支气管激发试验的广泛基层医院,以减少非典型哮喘的漏诊与误诊。
Objective: To explore the relationship between small airway index and atypical asthma and to establish the regression equation of small airway index to predict atypical asthma. Methods: A total of 612 patients with small airway disease in our Department of Respiratory Clinic were examined by bronchial provocation test. The positive rates of small airway disease and airway hyperresponsiveness were compared. Logistic regression analysis was used to establish the small airway index to predict SARS. Asthma regression equation. Results: A total of 543 bronchial provocation tests were positive in 612 patients with small airway disease. The positive rate was 88.73%. Among them, 531 cases were diagnosed as asthma. The positive rate of asthma with airway hyperresponsiveness was 97.79% Predict the positive rate of atypical asthma was 86.76%. Logistic regression analysis showed that the small airway index MMEF had the highest predictive value of asthma (P <0.01). The regression equation of small airway index predicting atypical asthma was: P = Exp (7.486-0.091 × MMEF-0.046 × FEF_ (50%) - 0.018 × FEF_ (75%)) / 1 + Exp (7.486-0.091 × MMEF- 0.046 × FEF_ (50%) - 0.018 × FEF_ (75%))] Exp (B) = 0.913. Conclusion: The detection of small airway index is simple and convenient, and it is suitable for a wide range of grass-roots hospitals in our country that can not carry out the bronchial provocation test to reduce the missed diagnosis and misdiagnosis of atypical asthma.