摘要
目的比较心肺功能运动试验与静态肺功能测定结果的灵敏度和特异度,探讨心肺功能运动试验在尘肺伤残程度鉴定中的运用。方法选取Ⅰ期煤工尘肺病人69名,正常对照182名,所有对象进行心肺功能运动试验和静态肺功能测定;计算灵敏度、特异度,判断肺损伤的一致性和相关性。结果静态肺功能指标中,FVC特异度最高(91.2%),但灵敏度最低(28.9%);RV/TLC%灵敏度最高(84.5%),但特异度最低(61.5%)。在运动试验指标中,最大摄氧量和调整的最大二氧化碳通气当量的特异度分别为97.4%和93.5%,灵敏度仅为34.4%和75.0%,似然比、准确率高于静态肺功能指标。运动试验指标与静态肺功能指标判断损伤之间有相关性和一致性,但相关程度和一致程度不高。结论运动试验指标与静态肺功能指标在相同程度肺损伤评定上有很大差异,静态肺功能不能准确评定体力能力的大小和丧失,在我国尘肺伤残评定方面应考虑采用心肺功能运动试验。
Objective To compare the sensitivity and specificity of cardiopulmonary exercise test （CPET） with those of resting pulmonary function test （PFT）, in order to approach to applying CPET for evaluating the impairment and disability of pulmonary function due to pneumoconiosis. Method Totally, 251 subjects were recruited and divided into two group, 69 patients with pneumoconiosis of stage Ⅰ, and 182 normal controls unexposed to dust. They were determined by CPET and resting PFT. The sensitivity and specificity of the tests, and consistence and correlation between CPET and resting PFT were calculated. Result In PFT, FVC% showed the highest specificity （91.2%） and the lowest sensitivity （28.9%）, but RV/TLC% showed the highest sensitivity （84.5%） and the lowest specificity （61.5%）. However, in CPET, the specificity of maximal oxygen upfake （VO2zmax） and adjusted maximal ventilator）, equivalent for CO2 （AdVE/VCO2max） were 97.4% and 93.5%, respectively, and the sensitivities of those were 34.4% and 75.0%, respectively. The likelihood ratio and accuracy of CPET were higher than those of resting PFT. There were only weak or moderate correlationship and consistence between CPET and resting PFT. Conclusion There existed a large difference in judging pulmonary impairment of the same degree between CPET and resting PFT. Maximal physical capacity and its loss could not precisely be predicted by resting PFT. For our country, CPET should be considered to use in evaluating pulmonary function impairment due to pneumoconiosis.
出处
《中国工业医学杂志》
CAS
北大核心
2005年第5期269-272,共4页
Chinese Journal of Industrial Medicine
关键词
心肺功能运动试验
静态肺功能
尘肺
损害/伤残
评价
Cardiopulmonary exercise test
Resting pulmonary function test
Pneumoconiosis
Impairment/disability
Evaluation
