Ciappi Giuliano, Corbo Giuseppe, Valente Salvatore
Istituto di Medicina Interna e Geriatria, Servizio di Fisiopatologia Respiratoria, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Roma.
Ann Ist Super Sanita. 2003;39(4):529-47.
Functional diagnosis of chronic obstructive pulmonary disease is important for identifying and quantifying airflow limitation, reversibility, disease severity and exacerbations. Functional diagnosis is also important for long-term therapeutic monitoring and for establishing the need for pulmonary rehabilitation. From the functional standpoint, chronic obstructive pulmonary disease is characterised by a progressive airflow limitation which is not fully reversible. Spirometry is the gold standard for diagnosing the disease and monitoring its progression as it is non-invasive, standardised, reproducible, and objective. Spirometry should measure forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the ratio of these two measurements. Post-bronchodilator FEV1 < 80% of the predicted value and FEV1/FVC ratio < 70% confirms the diagnosis of chronic obstructive pulmonary disease.
慢性阻塞性肺疾病的功能诊断对于识别和量化气流受限、可逆性、疾病严重程度及急性加重至关重要。功能诊断对于长期治疗监测以及确定肺康复需求也很重要。从功能角度来看，慢性阻塞性肺疾病的特征是气流受限呈进行性且不完全可逆。肺量测定法是诊断该疾病及其病情进展监测的金标准，因为它具有非侵入性、标准化、可重复性和客观性。肺量测定应测量一秒用力呼气容积（FEV1）、用力肺活量（FVC）以及这两个测量值的比值。支气管扩张剂使用后FEV1<预测值的80%且FEV1/FVC比值<70%可确诊慢性阻塞性肺疾病。
