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为探讨以 PD2 0 - PEF替代 PD2 0 - FEV1作为气道反应性判定指标的可行性 ,对 6 4例有呼吸系统症状者和 6 2例无症状者进行乙酰甲胆碱支气管激发试验 ,同步记录 PEF和 FEV1,计算 PD2 0 - PEF和 PD2 0 - FEV1。虽然 PD2 0 - PEF和 PD2 0 - FEV1之间有较强的直线相关关系 (P<0 .0 0 1) ,但两者之间有显著差异 (P<0 .0 0 5 ) ;若以 PD2 0 - FEV1作为金标准 ,在有症状组中以 PD2 0 - PEF作为气道反应性判定指标的敏感性 (72 .7% )、特异性 (73.8% )、阳性符合率(5 9.3% )、阴性符合率 (83.8% )均不甚高 ;在无症状组中敏感性 (6 6 .7% )和阳性符合率 (40 .0 % )仍低 ,而特异性(89.2 % )和阳性符合率 (96 .2 % )较高。认为 PD2 0 - PEF作为无症状群体的流行病学筛选指标以除外气道反应性正常者可能具有一定价值 ,但替代 PD2 0 - FEV1作为气道反应性指标用于临床工作则欠妥当
To explore the feasibility of using PD2 0 - PEF in place of PD2 0 - FEV1 as an indicator of airway responsiveness, 64 methamphetamine bronchial provocation tests were performed on 64 patients with respiratory symptoms and 62 asymptomatic patients, and simultaneous recording PEF and FEV1, PD2 0 - PEF and PD2 0 - FEV1 were calculated. Although there was a strong linear relationship between PD2 0 - PEF and PD2 0 - FEV1 (P <0. 001), there was a significant difference between the two (P <0.05) 0 - FEV1 as the gold standard, the sensitivity (72.7%), specificity (73.8%) and positive coincidence rate (53.3%) of PD2 0 - PEF in symptomatic group as indicators of airway responsiveness (83.8%) in the asymptomatic group. The sensitivity (66.7%) and the positive coincidence rate (40.0%) in the asymptomatic group were still low, while the specificity (89.2%) and the positive coincidence rate (96.2%) higher. PD2 0 -PEF as an epidemiological screening index for asymptomatic populations may be of value in patients with normal airway reactivity, but it is inappropriate to use PD20-FEV1 as an airway responsiveness indicator in clinical practice