Pistelli Francesco, Bottai Matteo, Carrozzi Laura, Baldacci Sandra, Simoni Marzia, Di Pede Francesco, Viegi Giovanni
U.O. Pneumologia e Fisiopatologia Respiratoria Universitaria, Dipartimento Cardio-Toracico, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Respir Med. 2007 Apr;101(4):814-25. doi: 10.1016/j.rmed.2006.06.032. Epub 2006 Sep 12.
Aim of this study was to derive new lung function reference equations and compare the predicted values with those from three sets of existing reference equations: one derived from a Northern Italy population and the two others widely used in European (ECCS) and American (NHANES III) clinical practice. Reference equations for flow-volume curve indexes and VC were derived on 497 normal subjects, aged 8-74, from the epidemiological survey in Pisa, Central Italy (1991-1993). By applying natural cubic splines, one single smooth and continuous equation for the entire age range was provided for each index, separately by gender. Along with age and height, reference values also depended on BMI. Differences among the four reference equations for FEV(1), FVC, VC were quantified for average subjects. The magnitude largely varied over the age range in both genders, reaching up to half litre of air volume at specific ages. Age-gender-specific prevalence rates of airway obstruction, as defined by the ERS criterion, largely varied by applying the considered equations, the differences ranging from -3% to 28%. The observed discrepancies confirm that reference equations should be derived from a population most similar to that for which the equations are to be used and based on measurements obtained by the same instrument and testing procedures, in order to minimize technical variability in lung function both for clinical and epidemiological purposes.
本研究的目的是推导新的肺功能参考方程，并将预测值与三组现有参考方程的预测值进行比较：一组来自意大利北部人群，另外两组在欧洲（ECCS）和美国（NHANES III）临床实践中广泛使用。流量-容积曲线指标和肺活量（VC）的参考方程是根据1991 - 1993年意大利中部比萨市的流行病学调查中497名年龄在8 - 74岁的正常受试者推导得出的。通过应用自然三次样条函数，按性别分别为每个指标提供了一个适用于整个年龄范围的单一平滑连续方程。除年龄和身高外，参考值还取决于体重指数（BMI）。对平均受试者，定量分析了四种FEV(1)、FVC、VC参考方程之间的差异。在两个性别中，差异幅度在整个年龄范围内变化很大，在特定年龄时达到半升的气量差异。按照ERS标准定义的气道阻塞的年龄-性别特异性患病率，应用所考虑的方程时差异很大，差异范围从 - 3%到28%。观察到的差异证实，参考方程应从与使用该方程的人群最相似的人群中推导得出，并基于同一仪器和测试程序获得的测量值，以便在临床和流行病学层面将肺功能的技术变异性降至最低。
