Barisione G, Crimi E, Bartolini S, Saporiti R, Copello F, Pellegrino R, Brusasco V
Dipartimento di Medicina Interna, Unità Operativa Medicina Preventiva e del Lavoro, Laboratorio di Fisiopatologia Respiratoria, Università di Genova, Azienda Ospedaliera Universitaria San Martino, Genova, Italy.
Eur Respir J. 2009 Jun;33(6):1396-402. doi: 10.1183/09031936.00183708. Epub 2009 Feb 5.
The aim of the present study was to determine whether the combination of low forced expiratory volume in 1 s (FEV(1))/vital capacity (VC) ratio with normal FEV(1) represents a physiological variant or a sign of early airflow obstruction. We studied 40 subjects presenting with low FEV(1)/VC, but FEV(1) within the range of normality predicted by European Respiratory Society reference equations, and 10 healthy controls. All subjects completed two questionnaires and underwent comprehensive pulmonary function testing, which included methacholine challenge and single-breath nitrogen wash-out. According to the questionnaires, the subjects were assigned to three groups, i.e. rhinitis (n = 8), bronchial asthma (n = 13) and chronic obstructive pulmonary disease (COPD; n = 12). Subjects with negative responses to questionnaires were assigned to an asymptomatic group (n = 7). Airway hyperresponsiveness was found in four subjects of the rhinitis group, all of the asthma group, and 10 of the COPD group; in the last two groups, it was associated with signs of increased airway closure and gas trapping. Bronchodilator response to salbutamol was positive in only a few individuals across groups. In the asymptomatic group, no significant functional changes were observed, possibly suggesting dysanaptic lung growth. In subjects with low FEV(1)/VC and normal FEV(1), questionnaires on respiratory symptoms together with additional pulmonary function tests may help to clarify the nature of this pattern of lung function.
本研究的目的是确定一秒用力呼气容积（FEV(1)）/肺活量（VC）比值低而FEV(1)正常的情况是一种生理变异还是早期气流受限的迹象。我们研究了40名FEV(1)/VC比值低但FEV(1)在欧洲呼吸学会参考方程预测的正常范围内的受试者，以及10名健康对照者。所有受试者均完成两份问卷并接受全面的肺功能测试，包括乙酰甲胆碱激发试验和单次呼吸氮洗脱试验。根据问卷，受试者被分为三组，即鼻炎组（n = 8）、支气管哮喘组（n = 13）和慢性阻塞性肺疾病（COPD；n = 12）。对问卷回答为阴性的受试者被归入无症状组（n = 7）。在鼻炎组的4名受试者、所有哮喘组受试者以及COPD组的10名受试者中发现气道高反应性；在后两组中，气道高反应性与气道闭合增加和气体潴留的体征相关。各组中只有少数个体对沙丁胺醇的支气管扩张反应呈阳性。在无症状组中，未观察到明显的功能变化，这可能提示肺发育不协调。对于FEV(1)/VC比值低而FEV(1)正常的受试者，关于呼吸症状的问卷以及额外的肺功能测试可能有助于明确这种肺功能模式的性质。
