Pulmonary Department, Johannes Gutenberg-University, Mainz, Germany.
Respir Med. 2011 Feb;105(2):316-21. doi: 10.1016/j.rmed.2010.11.017. Epub 2010 Dec 9.
Forced inspiratory measures have been described to reflect the reduction in dyspnoea upon bronchodilation in severe COPD. Based on this we evaluated the applicability and usefulness of a portable device for the assessment of forced inspiration. In 37 patients with COPD (GOLD II/II/IV n = 16/15/6, mean ± SD FEV(1) 46.2 ± 15.4%pred) lung function was recorded prior to inhalation of 24 μg formoterol and 30 min later. Assessments comprised spirometry including forced inspiration, body plethysmography, maximum inspiratory flow (InCheck, Clement Clarke), and changes in dyspnoea via visual analogue scale (VAS). The sequence was repeated on a second day to assess reproducibility. Bronchodilation by formoterol was detectable in all functional indices (p < 0.05 each) except total lung capacity. FEV(1) improved by (mean ± SD) 11.1 ± 10.3%, forced inspiratory volume in 1s (FIV(1)) by 11.6 ± 13.5%, inspiratory peak flow (PIF) by 10.7 ± 16.2%, and inspiratory flow determined by the InCheck device (IF-IC) by 11.9 ± 14.4%. Remarkably, the changes of IF-IC (p < 0.001) but not those of other measures except FIV(1) (p < 0.05) were related to those of dyspnoea. Effects on IF-IC showed reproducibility comparable to that of other indices. The results suggest that a simple, portable device for recording forced inspiration could be useful in monitoring COPD, as a functional correlate of acute changes in dyspnoea.
在严重 COPD 患者中，用力吸气措施可反映支气管扩张后呼吸困难的减轻。基于此，我们评估了一种便携式设备评估用力吸气的适用性和实用性。在 37 例 COPD 患者（GOLD II/II/IV，n = 16/15/6，FEV1 平均值 ± 标准差 46.2 ± 15.4%预计值）中，在吸入 24μg 福莫特罗前和 30 分钟后记录肺功能。评估包括用力肺活量（包括用力吸气）、体描法、最大吸气流量（InCheck，Clement Clarke）和通过视觉模拟量表（VAS）评估呼吸困难的变化。第二天重复该序列以评估可重复性。除了总肺容量外，福莫特罗的支气管扩张在所有功能指标（p < 0.05）中均有检测到。FEV1 改善（平均值 ± 标准差）11.1 ± 10.3%，1 秒用力吸气量（FIV1）改善 11.6 ± 13.5%，吸气峰流速（PIF）改善 10.7 ± 16.2%，InCheck 设备测定的吸气流量（IF-IC）改善 11.9 ± 14.4%。值得注意的是，IF-IC 的变化（p < 0.001），但除了 FIV1 外的其他指标（p < 0.05）的变化与呼吸困难的变化无关。IF-IC 的作用显示出与其他指标相当的可重复性。结果表明，一种简单的便携式记录用力吸气的设备可能对监测 COPD 有用，因为它是呼吸困难急性变化的功能相关指标。
