Accuracy of maximal expiratory flow-volume curve curvilinearity and fractional exhaled nitric oxide for detection of children with atopic asthma / 소아과

PURPOSE: Airway pathology in children with atopic asthma can be reflected by the concave shape of the maximal expiratory flow-volume (MEFV) curve and high fractional exhaled nitric oxide (FeNO) values. We evaluated the capacity of the curvilinearity of the MEFV curve, FeNO, and their combination to distinguish subjects with atopic asthma from healthy individuals. METHODS: FeNO and angle β, which characterizes the general configuration of the MEFV curve, were determined in 119 steroid-naïve individuals with atopic asthma aged 8 to 16 years, and in 92 age-matched healthy controls. Receiver operating characteristic (ROC) curve analyses were performed to determine the cutoff points of FeNO and angle β that provided the best combination of sensitivity and specificity for asthma detection. RESULTS: Asthmatic patients had a significantly smaller angle β and higher FeNO compared with healthy controls (both, P<0.001). For asthma detection, the best cutoff values of angle β and FeNO were observed at 189.3° and 22 parts per billion, respectively. The area under the ROC curve for the combination of angle β and FeNO improved to 0.91 (95% confidence interval [CI], 0.87–0.95) from 0.80 (95% CI, 0.75–0.86; P<0.001) for angle β alone and 0.86 (95% CI, 0.82–0.91; P=0.002) for FeNO alone. In addition, the combination enhanced sensitivity with no significant decrease in specificity. CONCLUSION: These data suggest that the combined use of the curvilinearity of the MEFV curve and FeNO is a useful tool to differentiate between children with and without atopic asthma.

MEASUREMENT OF WAXIMAL EXPIRATORY FLOW-VOLUME CURVE IN HEALTHY SUBJECTS AND PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE / 西安交通大学学报(医学版)

The maximal expiratory flow-volume (MEFV) curve were measured in 195 healthy adults. The results indicated that the values of the peak expiratory flow rate, V_(75), V_(50) and V_(25), were all higher in males than in females, and the higher the age, the lower the end expiratory flow rate. The end expiratory flow rate in chronic obstructive pulmonary disease (COPD) was decreased as the disease deteriorated. In healthy subjects, the V_(50)/V_(35) was increased with age, while in COPD patients V_(50) was decreased. The more severe the condition, the lower the rate. The authors suggest that the measurement of MEFV be used as a simple valuable method to evaluate small air way functiovs.

DIAGNOSTIC VALUE OF MEAN TANGENT CURVE OF MAXIMAL EXPIRATORY FLOW-VOLUME CURVE IN SMALL AIRWAY DISEASE / 第二军医大学学报

On the basis of the measurement of maximal expiratory flow-volumo (MEFV) curve mean tangent curve(MTC)was calculated in 167 healthy nonsmolters, 67 patients with chronic bronchitis and 23 patients with restrictive diseases.Four paa-metfrs including MTC in 75-50%VC (MTC1), in 50-25 % VC (MTC2), in 25 % VC-RV(MTC3)and ratio of MTC: to MTC3(MTCE)wer3 recorded.The MEFV curve could be expresssd accurately and quantitatively by all these measurement values and the data of MTC could be used for differential diagnosis between restrictive disease and obstructive diseas; of the lung.Thes: results suggest that MTC is more sensitive for detecting early changes in small airway disease, and especially MTCR is more useful