Istituto di Ricovero e Cura a Carattere Scientifico-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
Allergy Asthma Proc. 2012 Jan-Feb;33(1):e5-8. doi: 10.2500/aap.2012.33.3524.
Forced expiratory volume in 1 second (FEV1) is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that forced expiratory flow at 25-75% (FEF(25-75)) could be more sensitive than FEV1 to detect slight airways obstruction. In this regard, a cutoff FEF(25-75) value has been recently established in a group of asthmatic children: FEF(25-75) < 65% of predicted has been considered impaired. However, the considered population was specifically selected. Therefore, the aim of the present study was to confirm an FEF(25-75) cutoff value in a large cohort of asthmatic children. Seven hundred allergic children (493 male subjects; median age, 11 years) with controlled and partly controlled asthma were evaluated by performing spirometry and skin-prick tests. Three hundred thirteen (44.7%) patients had FEF(25-75%) values of <65% of predicted. Two predictors were significantly associated with impaired FEF(25-75) values: (i) sensitization to perennial allergens (adjusted odds ratio [OR(Adj)], 3.4) and (ii) FEV(1) ≤ 86% of predicted (OR(Adj), 3.8). This study, conducted in real life, could suggest that FEF(25-75) value of <65% of predicted may be considered abnormal.
一秒用力呼气容积（FEV1）被认为是哮喘诊断和随访的重要参数。然而，有人提出，用力呼出流量在 25%到 75%（FEF（25-75））可能比 FEV1 更能敏感地检测到轻微的气道阻塞。在这方面，最近在一组哮喘儿童中建立了一个 FEF（25-75）的截止值：FEF（25-75）<预测值的 65%被认为是受损的。然而，考虑到的人群是专门选择的。因此，本研究的目的是在一大群哮喘儿童中确认 FEF（25-75）的截止值。对 700 名过敏性儿童（493 名男性；中位年龄 11 岁）进行了肺量测定和皮肤点刺试验。313 名（44.7%）患者的 FEF（25-75）值<预测值的 65%。有两个预测因素与受损的 FEF（25-75）值显著相关：（i）对常年过敏原的致敏（调整后的比值比[OR（Adj）]，3.4）和（ii）FEV1≤预测值的 86%（OR（Adj）），3.8）。这项在现实生活中进行的研究表明，FEF（25-75）值<预测值的 65%可能被认为是异常的。
