University of Kentucky, Lexington, 40536, USA.
COPD. 2010 Oct;7(5):323-30. doi: 10.3109/15412555.2010.510161.
Chronic Obstructive Pulmonary Disease (COPD) is defined by being "not fully reversible", most guidelines recommend measurement of lung function after the administration of a bronchodilator. The objective of this study was to compare bronchodilator responsiveness (significant improvement in the FEV(1) or FVC) to full-, partial- or "inverse'" reversibility in obstruction status in a population-based sample in Southeastern Kentucky. The study population was selected using random digit dialing of an adult population in Southeastern Kentucky as part of the Burden of Lung disease (BOLD) project. Lung function was assessed using spirometry pre- and post-bronchodilation. Subjects presence and severity of COPD was classified using modified Global Obstructive Lung Disease (GOLD) criteria. We examined the relation between changes in "obstruction" status (based on the FEV(1)/ FVC of 0.7) and the presence of "significant bronchodilator responsiveness" (based on ≥ 12% improvement in the FEV(1) or the FVC). The final population with acceptable pre- and post-bronchodilator spirometry included 440 participants. 32/440 subjects (7.3%) changed from obstructed to unobstructed (full-reversibility), 19/440 (4.3%) changed from unobstructed to obstructed ("inverse"-reversibility), 389/440 (88.4%) had either no-change or partial-reversibility, and 65/440 (14.8%) had bronchodilator responsiveness. Among those with full-reversibility, only 9/32 (28.1%) had bronchodilator responsiveness, whereas among subjects with "inverse"-reversibility, 10/19 (52.6%) had bronchodilator responsiveness. Among all subjects with bronchodilator responsiveness, only 19/65 (29.2%) changed categories. Our findings suggest that significant bronchodilator responsiveness is not the same as "reversibility" of "obstruction", even though these terms are often used interchangeably.
慢性阻塞性肺疾病（COPD）的定义为“不完全可逆”，大多数指南建议在给予支气管扩张剂后测量肺功能。本研究的目的是比较支气管扩张剂反应性（FEV1 或 FVC 显著改善）与东南肯塔基州基于人群样本中阻塞状态的完全、部分或“反向”可逆性。研究人群是通过东南肯塔基州成人人群的随机数字拨号选择的，作为肺部疾病负担（BOLD）项目的一部分。使用支气管扩张前后的肺活量测定法评估肺功能。使用改良全球阻塞性肺病（GOLD）标准对受试者的 COPD 存在和严重程度进行分类。我们检查了“阻塞”状态变化（基于 FEV1/FVC 为 0.7）与“显著支气管扩张剂反应性”（基于 FEV1 或 FVC 改善≥ 12%）之间的关系。最终纳入可接受的支气管扩张前后肺活量测定法的人群包括 440 名参与者。440 名受试者中有 32/440（7.3%）从阻塞性转变为非阻塞性（完全可逆），19/440（4.3%）从非阻塞性转变为阻塞性（“反向”可逆），389/440（88.4%）无变化或部分可逆，65/440（14.8%）有支气管扩张剂反应性。在完全可逆的患者中，仅有 32/32（9/32）（28.1%）有支气管扩张剂反应性，而在“反向”可逆的患者中，19/19（10/19）（52.6%）有支气管扩张剂反应性。在所有有支气管扩张剂反应性的患者中，仅有 65/65（19/65）（29.2%）改变了分类。我们的发现表明，显著的支气管扩张剂反应性与“阻塞”的“可逆性”并不相同，尽管这两个术语经常互换使用。
