Falaschetti E, Laiho J, Primatesta P, Purdon S
Dept of Epidemiology and Public Health, Royal Free and University College Medical School, London, UK.
Eur Respir J. 2004 Mar;23(3):456-63. doi: 10.1183/09031936.04.00055204.
The aim of this study was to derive new spirometric reference equations for the English population, using the 1995/1996 Health Survey for England, a large nationally representative cross-sectional study. The measurements used were the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) of a sample of 6,053 "healthy" (nonsmokers with no reported diagnosis of asthma or respiratory symptoms) White people aged > or = 16 yrs. Multiple regression analysis, with age and height as predictors, was carried out to estimate prediction equations for mean FEV1, FVC and FEV1/FVC, separately for males and females. A method based on smoothing multiple estimates of the fifth percentiles of residuals was used to derive prediction equations for the lower limit of normal lung function. The new equations fit the current English adult population considerably better than the European Coal and Steel Community equations, and the proportions of people with "low" (below the fifth percentile) lung function are closer to those expected throughout the whole adult age range (16 to > 75 yrs). For the age ranges the studies share in common, the new equations give estimates close to those derived from other nonlinear equations in recent studies. It is, therefore, suggested that these newly developed prediction equations be used for the White English population in both epidemiological studies and clinical practice.
本研究旨在利用1995/1996年英国健康调查(一项具有全国代表性的大型横断面研究),为英国人群推导新的肺功能参考方程。所采用的测量指标为6053名年龄≥16岁的“健康”(无吸烟史且无哮喘或呼吸道症状诊断报告)白人样本的一秒用力呼气量(FEV1)和用力肺活量(FVC)。以年龄和身高作为预测变量进行多元回归分析,分别估算男性和女性的平均FEV1、FVC及FEV1/FVC的预测方程。采用基于残差第五百分位数平滑多重估计的方法推导正常肺功能下限的预测方程。新方程对当前英国成年人群的拟合效果明显优于欧洲煤钢共同体方程,且肺功能“低”(低于第五百分位数)的人群比例在整个成年年龄范围(16至>75岁)内更接近预期值。对于本研究与其他研究共有的年龄范围,新方程得出的估计值与近期研究中其他非线性方程得出的估计值相近。因此,建议在流行病学研究和临床实践中,将这些新开发的预测方程应用于英国白人人群。