Clinic for Pneumology, University Hospital, Basel, Switzerland.
Respiration. 2010;79(6):469-74. doi: 10.1159/000243162. Epub 2009 Sep 26.
Diagnosis of chronic obstructive pulmonary disease (COPD) and its severity determination is based on spirometry. The quality of spirometry is crucial.
Our aim was to assess the quality of spirometry performed using a spirometer with automated feedback and quality control in a general practice setting in Switzerland and to determine the prevalence of airflow limitation in smokers aged > or =40 years.
Current smokers > or =40 years of age were consecutively recruited for spirometry testing by general practitioners. General practitioners received spirometry training and were provided with an EasyOne spirometer. Spirometry tests were assigned a quality grade from A to D and F, based on the criteria of the National Lung Health Education Program. Only spirometry tests graded A-C (reproducible measurements) were included in the analysis of airflow limitation.
A total of 29,817 spirometries were analyzed. Quality grades A-D and F were assigned to 33.9, 7.1, 19.4, 27.8 and 11.8% of spirometries, respectively. 95% required < or =5 trials to achieve spirometries assigned grade A. The prevalence of mild, moderate, severe and very severe airway obstruction in individuals with spirometries graded A-C was 6, 15, 5 and 1%, respectively.
Spirometries in general practice are of acceptable quality with reproducible spirometry in 60% of measurements. Airway obstruction was found in 27% of current smokers aged > or =40 years. Office spirometry provides a simple and quick means of detecting airflow limitation, allowing earlier diagnosis and intervention in many patients with early COPD.
慢性阻塞性肺疾病（COPD）的诊断及其严重程度的确定基于肺量测定。肺量测定的质量至关重要。
我们旨在评估在瑞士的普通诊所中使用具有自动反馈和质量控制功能的肺量计进行肺量测定的质量，并确定>或=40 岁吸烟者气流受限的患病率。
连续招募年龄>或=40 岁的当前吸烟者进行肺量测定测试。普通医生接受了肺量测定培训，并配备了 EasyOne 肺量计。根据美国国家肺脏健康教育计划的标准，肺量测定测试被评为 A 到 D 和 F 级。仅包括 A-C 级（可重复测量）的肺量测定测试进行气流受限分析。
共分析了 29817 次肺量测定。A-D 和 F 级的肺量测定分别占 33.9%、7.1%、19.4%、27.8%和 11.8%。95%的肺量测定需要<或=5 次试验即可达到 A 级。在 A-C 级肺量测定中，轻度、中度、重度和非常重度气道阻塞的患病率分别为 6%、15%、5%和 1%。
普通诊所的肺量测定质量可接受，60%的测量结果具有可重复性。在>或=40 岁的当前吸烟者中，发现 27%存在气道阻塞。肺量测定可提供一种简单快速的检测气流受限的方法，允许对许多早期 COPD 患者进行更早的诊断和干预。
