摘要
目的:分析健康人1 s用力呼气容积与用力肺活量比值的变异情况,并据此评价2001年GOLD和2002年中华呼吸学会制定的COPD诊治指南中将FEV1/FVC<70%作为COPD诊断分级先决条件的普适性和可行性。方法:测定260例健康人的用力肺活量和最大呼气流量———容积曲线,并进行统计学处理,同时依年龄分为≤35、36-55及≥56岁3组进行统计学处理及比较分析。结果:260例健康人FEV1/FVC均值为83.1%,随着年龄的增加趋于下降,3个年龄组之间两相比较差异有显著性意义(P<0.05),其它指标如FVC%预计值、FEV3/FVC、PEF%预计值在<55岁下降不明显,>56岁下降幅度差异有显著性意义(P<0.05),FEV1%预计值则于健康人的各年龄阶段都未见显著下降。结论:FEV1/FVC的变异方向难以把握,尤其是COPD患者,其不似FEV1%预计值那样与COPD的病变程度具有良好的趋同性和平行性,作为COPD诊断分级的先决条件缺乏普适性且不能覆盖所有的COPD患者,临床实践中缺乏良好的可操作性,因此FEV1/FVC<70%作为COPD诊断分级的先决条件缺乏充分的理论依据,建议COPD诊治指南加以修订。
Objective： To analyze FBV1/FVC variation in healthy persons, and to evaluate the availability and credibility of using FEV1/FVC〈70% for initial diagnosis and assessing the severity of chronic obstructive lung disease （COPD）, which based on the guideline of global initiative for chronic obstructive lung disease （GOLD） in 2001 and the diagnostic criteria of COPD made by Chinese Medical Association in 2002. Methods： 260 normal persons were divided into three different groups, age 435, age between 36 and 55, and age ≥56 years. FEV1, FVC and maximal rnidexpiratory flow （MMEF） curve were checked and compared in these healthy persons respectively. Results： The average of FEV1/FVC in these 260 healthy people was 83.1% and decreased when aging, which showed significant difference among three age groups （P〈0.05）. Before the age of 55 years, other values such as FVC % predict, FEV3/FVC and PEF % predict were not decreased significantly, but after the age of 56 years these parameters were decreased dramatically （P〈0.05）. However, the value of FEV1% predict was not decreased significantly in different age groups. Conclusion： It＇s very difficult to predict the variation of FEV1/FVC ratio, especially in those COPD patients because it is not as a good parameter as FEV1 which has very good trend and parallel with the severity of COPD. It lacks of enough theoretical evidence when only using FEV1/FVC〈70% for initial diagnosis and assessing the severity of COPD since it is not so universal and sometimes can not cover all COPD patients. Therefore, we suggest to modify the COPD guideline for better clinical operational purpose.
出处
《中国康复》
2006年第5期316-318,共3页
Chinese Journal of Rehabilitation
