Fuhlbrigge A L, Kitch B T, Paltiel A D, Kuntz K M, Neumann P J, Dockery D W, Weiss S T
Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115-5805, USA.
J Allergy Clin Immunol. 2001 Jan;107(1):61-7. doi: 10.1067/mai.2001.111590.
FEV(1) is endorsed by the National Asthma Education and Prevention Program as a means for grading asthma severity. However, few data exist on the relationship between FEV(1) and asthma outcomes during long-term follow-up.
We explored the relationship between the percent predicted FEV(1) (FEV(1)%) and subsequent asthma attacks in a longitudinal study of pediatric lung health.
A retrospective cohort of 13,842 children (100,292 observations) seen annually over a 15-year interval was analyzed for measurement of pulmonary function, and a respiratory questionnaire was completed. Up to grade 9, a standard questionnaire was completed by a parent or guardian; thereafter it was completed by the patient. For each observation, the report of an attack during the past year was paired with FEV(1) recorded at the field survey 1 year earlier.
A progressive decrease in the proportion of individuals reporting an attack was associated with increasing decile of FEV(1)%. Two categorization schemes for FEV(1)% were examined: a scheme based on the National Asthma Education and Prevention Program recommendations (<60%, 60%-80%, and >80%), and an alternative scheme (<80%, 80%-100%, and >100%). In multivariate models, FEV(1)% was an independent predictor of attacks: among the parental report group, the odds ratios were 2.1 (95% CI, 1.3-3.4) and 1.4 (95% CI, 1.2-1.6) for FEV(1)% < 60% and FEV(1)% of 60% to 80% compared with FEV(1)% > 80%, respectively; and among the self-report group, odds ratios were 5.3 (95% CI, 2.2-12.9) and 1.4 (95% CI, 1.2-1.7) for FEV(1)% < 60% and FEV(1)% of 60% to 80% compared with FEV(1)% > 80%, respectively. With the alternative classification scheme, the relationship was similar, but the difference in risk between categories of FEV(1)% decreased.
The strong association between FEV(1)% and risk of asthma attack over the subsequent year supports an emphasis on objective measures of lung function in assessment of risk for adverse asthma outcomes.
第一秒用力呼气容积（FEV₁）被国家哮喘教育与预防计划认可为哮喘严重程度分级的一种方法。然而，关于长期随访期间FEV₁与哮喘结局之间关系的数据很少。
在一项儿童肺部健康纵向研究中，我们探讨了预测FEV₁百分比（FEV₁%）与随后哮喘发作之间的关系。
对一个回顾性队列进行分析，该队列包括13842名儿童（100292次观察），他们在15年期间每年接受一次检查，测量肺功能，并完成一份呼吸问卷。9年级及以下，由家长或监护人填写标准问卷；此后由患者本人填写。对于每次观察，将过去一年中哮喘发作的报告与一年前现场调查时记录的FEV₁进行配对。
报告发作的个体比例逐渐下降与FEV₁%的十分位数增加相关。研究了两种FEV₁%的分类方案：一种基于国家哮喘教育与预防计划的建议（<60%、60%-80%和>80%），另一种替代方案（<80%、80%-100%和>100%）。在多变量模型中，FEV₁%是发作的独立预测因素：在家长报告组中，与FEV₁%>80%相比，FEV₁%<60%和FEV₁%为60%-80%的比值比分别为2.1（95%CI，1.3-3.4）和1.4（95%CI，1.2-1.6）；在自我报告组中，与FEV₁%>80%相比，FEV₁%<60%和FEV₁%为60%-80%的比值比分别为5.3（95%CI，2.2-12.9）和1.4（95%CI，1.2-1.7）。采用替代分类方案时，关系相似，但FEV₁%类别之间的风险差异减小。
FEV₁%与次年哮喘发作风险之间的强关联支持在评估哮喘不良结局风险时强调肺功能的客观测量。
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