【摘要】 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。更多还原

【Abstract】 Objective The purpose of this study was to determine the efficacy of forced expiratory volume in six seconds(FEV6) as an alternative for forced vital capacity(FVC)and the fixed eat-off points for FEV1/FEV6 in the diagnostic screening for chronic obstructive pulmonary disease (COPD).Methods From August 2007 to December 2008,a total of 1210 spirometric examinations in were analyzed,FEV6 was measured on volume-time curves.The correlation between FEV1/FVC and FEV1/FEV6 was evaluated by the Kendall correlation test.Considering FEV1/FVC<70% as being the ’gold standard’ for obstruction,a ROC curve was used to determine the cut-off point for the FEV1/FEV6 ratio in the diagnostic screening for COPD.Results The Kendall correlation test revealed the FEV1/FEV6 and FEV1/FVC ratios were highly correlated (r=0.964,P<0.000).The best cut-off point for the FEV1/FEV6 ratio in the diagnostic screening for COPD was 71%,the sensitivity and specificity were 94.4 and 93.3%,respectively.Conclusion There is a strong correlation between FEV1/FVC and FEV1/FEV6.Using a FEV1/FEV6 cut-off of 71%,the sum of sensitivity and specificity were the greatest.The FEV1/FEV6 ratio can be a valid alternative for FEV1/FVC in the diagnosis screening for chronic obstrutive pulmonary disease.更多还原