Sibilancias y obstrucción de vías aéreas

Hernández Flix, S.; Casan, P.; Sanchis, J.

doi:10.1016/S0300-2896(15)31659-8

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 26. Issue 1.

Pages 3-7 (January - February 1990)

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Pages 3-7 (January - February 1990)

DOI: 10.1016/S0300-2896(15)31659-8

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Sibilancias y obstrucción de vías aéreas

Wheezing and airway obstruction

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S. Hernández Flix, P. Casan, J. Sanchis

Unitat de Funció Pulmonar. Hospital de la Santa Creu i de Sant Pau. Barcelona

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Se estudiaron 40 pacientes sometidos a evaluación funcional de rutina por asma o LCFA; se les asignó una puntuación según las sibilancias que presentaran antes y después de la administración de un broncodilatador y esta puntuación se correlacionó con el resultado de la espirometría y test broncodilatador.

Se obtuvo para la auscultación de sibilancias una sensibilidad del 75% y una especificidad del 81% en relación a la LCFA (considerada como FEV1/FVC ≤ 65%), y una sensibilidad del 75% y especificidad del 70% en relación a la prueba broncodilatadora, considerada como incremento de FEV1 > 11%. La correlación entre la puntuación de sibilancias y los valores de la espirometría se situó en general entre 0,40 y 0,50. Se observó el valor más alto (r = 0,523) entre las sibilancias y el incremento en el VEMS con el broncodilatador. La correlación más baja de las obtenidas, y única sin significación estadística, fue entre las sibilancias y el ápice de flujo. Si bien hay una relación significativa entre las sibilancias y la limitación al flujo aéreo y su reversibilidad, la espirometría sigue siendo indispensable para la valoración clínica de estos pacientes.

Forty-five patients undergoing routine functional study for asthma or LCFA were evaluated. They were assigned a score based on the degree of wheezing they had before and after the administration of a bronchodilator. This score was then correlated with the results of the spirometric study and the bronchodilator test.

Wheezing had a sensitivity of 75% and a specificity of 81% regarding LCFA (considered as FEV1/FVC ≤ 65%), and a sensitivity of 75% with a 70% specificity regarding the bronchodilator test, considered as an increase > 11% in FEV1. The correlation between the auscultation of wheezing and the spirometric values was generally between 0,40 and 0,50. The highest value (r = 0,523) was found between wheezing and the increase of FEV1 after the bronchodilator. The lowest correlation (the only nonsignificant one) was found between wheezing and peak flow. Although there is a signficant correlation between wheezing and the limitation to air flow and its reversibility, spirometry is still essential for the clinical evaluation of these patients.

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