Arizona Respiratory Center, University of Arizona, Tucson, Arizona 85724-5030, USA.
Thorax. 2010 Jun;65(6):499-504. doi: 10.1136/thx.2009.126052.
Recent studies have suggested that a restrictive pattern assessed with a single spirometric test is associated with increased morbidity and mortality. This study was undertaken to determine demographic, clinical and mortality profiles of subjects with either a recurrent or an inconsistent restrictive spirometric pattern assessed prospectively.
Data from 2048 adult participants in the population-based TESAOD study were analysed. Normal (forced expiratory volume in 1 s/forced vital capacity (FEV(1)/FVC) ratio >or=70% and FVC >or=80% predicted), restrictive (FEV(1)/FVC >or=70% and FVC <80% predicted) and obstructive (FEV(1)/FVC <70%) patterns were assessed at the enrollment survey in 1972 and in 11 subsequent follow-up surveys up to 1996. Demographic and clinical characteristics were measured at enrollment and vital status and cause of death were assessed at January 2005.
Overall, 12% of participants had a restrictive spirometric pattern at enrollment. They were less likely to be male, to smoke and to have asthma, and had lower IgE levels than subjects in the obstructive group. Among subjects with a restrictive pattern at enrollment, 38% developed an obstructive pattern during follow-up. The remaining 62% had either a recurrent (restrictive pattern >or=50% of follow-up surveys) or inconsistent (restrictive pattern <50% of follow-up surveys) longitudinal restrictive pattern. The recurrent and inconsistent restrictive groups had increased mortality risk for all-cause (adjusted HR 1.7 (95% CI 1.3 to 2.3) and 1.9 (95% CI 1.4 to 2.6), respectively), heart disease (2.0 (95% CI 1.3 to 3.1) and 2.7 (95% CI 1.7 to 4.3)), stroke (2.4 (95% CI 0.9 to 6.3) and 3.5 (95% CI 1.2 to 9.8)) and diabetes (8.0 (95% CI 2.9 to 21.8) and 6.0 (95% CI 1.9 to 19.2)).
The restrictive spirometric pattern identifies a pulmonary condition that is distinguishable from obstructive lung disease and is associated with an increased risk of life-threatening comorbidities.
最近的研究表明，使用单一肺量计测试评估的限制性模式与发病率和死亡率的增加有关。本研究旨在确定前瞻性评估的复发性或不一致性限制性肺量计模式受试者的人口统计学、临床和死亡率特征。
对基于人群的 TESAOD 研究的 2048 名成年参与者的数据进行了分析。正常（用力呼气量 1 秒/用力肺活量（FEV1/FVC）比>或=70%和 FVC>或=80%预计值）、限制性（FEV1/FVC>或=70%和 FVC<80%预计值）和阻塞性（FEV1/FVC<70%）模式在 1972 年的入组调查和随后的 11 项随访调查中进行评估，直到 1996 年。入组时测量人口统计学和临床特征，2005 年 1 月评估生存状态和死亡原因。
总体而言，12%的参与者在入组时具有限制性肺量计模式。与阻塞性组相比，他们不太可能是男性、吸烟和患有哮喘，并且 IgE 水平较低。在入组时具有限制性模式的受试者中，38%在随访期间发展为阻塞性模式。其余 62%的人要么有复发性（限制性模式>或=50%的随访调查），要么有不一致性（限制性模式<50%的随访调查）的纵向限制性模式。复发性和不一致性的限制性组的全因死亡率风险增加（调整后的 HR 分别为 1.7（95%CI 1.3 至 2.3）和 1.9（95%CI 1.4 至 2.6））、心脏病（2.0（95%CI 1.3 至 3.1）和 2.7（95%CI 1.7 至 4.3））、中风（2.4（95%CI 0.9 至 6.3）和 3.5（95%CI 1.2 至 9.8））和糖尿病（8.0（95%CI 2.9 至 21.8）和 6.0（95%CI 1.9 至 19.2））。
限制性肺量计模式可识别出一种与阻塞性肺疾病不同的肺部疾病，并与危及生命的合并症风险增加相关。
