Mehrparvar Amir Houshang, Mirmohammadi Seyed Jalil, Sohrabi Mohammad Mehdi
Department of Occupational Medicine, Shahid Rahnamoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Acta Med Iran. 2010 Jul-Aug;48(4):226-30.
Bronchial responsiveness to bronchodilator medications is usually tested to establish reversibility of airflow obstruction. Among the various tests to establish bronchodilator response, FEV1, FEF(25-75%) or FEF50%, and FVC are the most widely used. In a cross-sectional study, we assessed spirometric responses after administration of bronchodilator in 187 workers with obstructive pattern in spirometry. Considering responsiveness to bronchodilator (200 cc and 12% increase in FEV1 or FVC), the study cases were divided into responsive or non-responsive groups, and the average increase in spirometric indices were measured and compared between two groups. 35.8% of cases were responsive to bronchodilator. Among responsive cases, FEV1 was the most frequent index increased significantly; And PEF and FVC were the least frequent ones. The highest mean increase from baseline after administration of bronchodilator was observed in FEF75%. Increases in all indices were significantly higher in responsive group. The increase in FEV1% predicted was inversely correlated with baseline FEV1. In conclusion, we consider that FEV1 is the most reliable spirometric index for assessing bronchodilator response. And Bronchial reversibility has an inverse relationship with baseline measures.
通常会测试支气管对支气管扩张剂药物的反应性，以确定气流阻塞的可逆性。在各种用于确定支气管扩张剂反应的测试中，第一秒用力呼气容积（FEV1）、用力呼气流量（25%-75%）或用力呼气流量50%（FEF50%）以及用力肺活量（FVC）是使用最广泛的。在一项横断面研究中，我们评估了187名肺活量测定呈阻塞型的工人在使用支气管扩张剂后的肺量计反应。根据对支气管扩张剂的反应性（FEV1或FVC增加200毫升及12%），将研究病例分为反应组或无反应组，并测量和比较两组肺量计指标的平均增加量。35.8%的病例对支气管扩张剂有反应。在有反应的病例中，FEV1是最常显著增加的指标；而呼气峰值流速（PEF）和FVC是最不常增加的指标。在用力呼气流量75%（FEF75%）中观察到使用支气管扩张剂后相对于基线的最高平均增加量。反应组中所有指标的增加均显著更高。预测的FEV1%增加与基线FEV1呈负相关。总之，我们认为FEV1是评估支气管扩张剂反应最可靠的肺量计指标。并且支气管可逆性与基线测量值呈反比关系。
